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Stubborn ulcerative colitis responds to arthritis drug, review finds

nteraction between a person's genetic makeup and another factor, such as infection or the use of non-steroidal anti-inflammatory drugs, a class of painkillers that includes ibuprofen (Advil) and naproxen (Aleve).

The interactions may cause "an abnormal interaction between bacteria in the gut and the immune system," Higgins said.

Meanwhile, "mechanisms that lead to a reduction of inflammation in response to bacterial products are defective, so the body has a hard time 'resetting' itself, and the inflammation becomes chronic," said Gerald Dryden, Jr., M.D., an associate professor at the University of Louisville in Kentucky.

There are a number of drug treatments for colitis, including steroids, which reduce inflammation by dampening the body's immune system, and aminosalicylates, which also help control inflammation.

In some cases, however, the colon must be removed; some patients must use colostomy bags for the rest of their lives.

In recent years, researchers have begun looking at infliximab -- also known by the brand name Remicade -- as a possible treatment for moderate and severe colitis.

In the review studies, patients were given either infliximab or a placebo for moderate and severe cases of ulcerative colitis. All the patients failed treatment with steroids and/or other drugs that suppress the immune system.

Three intravenous infusions of infliximab (at zero, two and six weeks) were 3.2 times more likely than placebos to lead to remission of symptoms and two times more likely to induce a clinical response at eight weeks.

The researchers also found that a single infusion of infliximab was more effective than placebo in reducing the need for colectomy within three months.

Serious side effects were "not common" in the studies, but the authors report that infliximab can be dangerous to some patients.

The drug has been used to treat rheumatoid arthritis and Crohn's diseas
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Contact: Lisa Esposito
lesposito@cfah.org
Center for the Advancement of Health
11-Sep-2006


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