Patients with severe bowel disease could benefit from a new drug that can eliminate their distressing symptoms in just three months.
Etrasimod, a once-daily tablet, treats ulcerative colitis by binding to immune cells and preventing them from mistakenly attacking healthy tissue in the lining of the intestine.
In a recent trial, 27% of people who had not responded to any other treatment were found to be in remission after just 12 weeks, and 32% were asymptomatic after a year.
Ulcerative colitis can be debilitating, causing bloody diarrhea, extreme fatigue, loss of appetite and weightloss.
It can also trigger symptoms such as abdominal pain and digestive discomfort, similar to the more common problem of irritable bowel syndrome (IBS).
Etrasimod, a once-daily tablet, treats ulcerative colitis by binding to immune cells and preventing them from mistakenly attacking healthy tissue in the lining of the intestine.
Dr Sami Hoque, a gastroenterologist at Barts Health NHS Trust in London who led the UK arm of the etrasimod trial, described his results as “astonishing”.
He added: “When I first started treating ulcerative colitis there were very few options available and what we did caused serious side effects. The advantage of etrasimod is that it is highly selective, able to target unruly inflammatory cells without affecting the immune system as a whole.
It is an important addition to existing treatments for bowel disease and, unlike other therapies which involve injections, it comes in the form of a tablet to be taken once a day. It empowers patients, which means they can avoid regular hospital visits.
Ulcerative colitis is a long-term disorder that occurs when, for reasons that are not fully understood, the immune system goes into overdrive and attacks healthy body tissues in the lining of the large intestine or colon, causing inflammation and ulcers. It is one of the two main types of inflammatory bowel disease, along with Crohn’s disease.
The disease affects around 146,000 people in the UK, but experts suggest many more may go undiagnosed and up to one in ten over the age of 50 may have some form of the disease.
Patients can go for months without symptoms before being hit with a flare-up. During these episodes, some patients also experience joint pain, mouth ulcers, and irritated red eyes. In the most severe cases, they may also suffer from shortness of breath, palpitations and fever.
If doctors suspect colitis, they first take a stool sample to test for a protein called calprotectin – a sign of inflammation in the gut.
If there is a positive result, a gastroenterologist will perform further tests to look for physical signs of damage. This usually involves a colonoscopy, where a camera is inserted through the back passage and tissue is cut out for testing.
First-line treatment includes tablets or suppositories containing anti-inflammatories called aminosalicylates. These help manage mild flare-ups, but their effect wears off over time.
Other options include strong steroids that reduce inflammation but carry the risk of unpleasant side effects such as acne, mood swings and diabetes. Medicines that suppress the immune system can also be used, but they can make patients vulnerable to infections.
If these options fail, as in 15% of cases, surgery to remove the bowel may be the only option.
Dr Hoque said: “Etrasimod could be used in combination with existing treatments to strengthen the body’s defenses and avoid the need for surgery.”
The drug is not yet approved. However, experts hope the process will begin later this year.
Romit Zutshi, 42, from Chigwell in Essex, was diagnosed with bowel disease in 2015 and was treated with etrasimod as part of the Barts trial.
The father-of-a-married child first went to his GP after he started seeing blood in his stool and had to go to the toilet up to eight times a day.
He said: ‘Not knowing what was wrong with me was scary. I started losing weight and was constantly tired from waking up all night to rush to the bathroom.
Having failed to respond to other medications, he was enrolled in the etrasimod trial at Barts in 2020 and noticed “drastic improvement”.
He added: “I feel more confident and able to live more or less like a normal person. I used to worry constantly about being near the toilet when I left the house and couldn’t exercise properly because I got tired so easily, but that’s no longer a problem.
WEIRD SCIENCE: Homemade drug that left fungus in man’s veins
At the hospital, tests showed the man’s liver and kidneys were failing as the fungus psilocybe cubensis grew in his blood.
A man has developed a life-threatening fungal infection after fungi started growing in his blood.
The 30-year-old American told doctors he had been trying to find a way to deal with his mental health issues.
After reading that psilocybin, a hallucinogenic compound found in magic mushrooms, could help cancer patients suffering from anxiety and depression, he boiled it into a tea and injected it.
Over the next few days, he became nauseous, confused, and started vomiting blood.
At the hospital, tests showed his liver and kidneys were failing as the fungus psilocybe cubensis was growing in his blood.
The man spent 22 days in hospital, eight of them in intensive care, with blood filtering and two antibiotic treatments, according to the Journal Of The Academy Of Consultation-Liaison Psychiatry.
YES PLEASE
Le Labo coffee body scrub
500g, £37
Provides gentle exfoliation but using coffee beans rather than the harmful microplastics found in many scrubs.
And it smells good enough to eat.
lelabofragrances.com
Le Labo coffee body scrub
#Ulcerative #colitis #eliminated #months #daily #tablet