A recent news story came about pig whipworm treatment for Crohn’s. Basically the idea is that the worms is based on the “hygiene hypothesis” which basically states that autoimmune diseases are higher in countries with higher levels of sanitation. In countries that are not as sanitized they are exposed to parasites which seem to make autoimmune diseases less likely. In a related note recently Coronado Biosciences (maker of the genetic pig whipworm) was granted a patent that doesn’t expire until January 2029. According to the clinical trial information here the trial should be complete by August 2013. A partner of Coronado, called Dr. Falk Pharma GmbH is also doing a clinical trial that will be completed by December 2013 (however it began in November 2010).
This news story from ABC talks about a man who actually ingested the worms and felt better. The 33 year old man ingested 2,500 worm eggs every 2 weeks for 3 months (the man had the disease since he was a teenager). What is interesting is that most of his Crohn’s symptoms disappeared. For those grossed out by worms they are microscopic and can't be seen in water. In fact the guy who took the worms just said it tasted like salty water. The inflammation markers in his blood also decreased as well. He however had to stop because the treatment was costing around $4,500 (mainly since it is not FDA approved ).
A trial is now being conducted by Coronado Biosciences. The company is enrolling 220 patients using 7,500 pig worm eggs every 2 weeks for 3 months. Some prior studies have yielded pretty good results. This study showed that 79.3% of patients showed a response with no adverse affects. In this study from 2004 (looked at colitis and not Crohn’s) after 3 months of treatment 43.3% of patients saw improvement. I should point out that the worms were from the United States Department of Agriculture. Treatment in this trial also did not induce side effects. The drug does have the possibility to become a blockbuster as it has shown some promise for other autoimmune diseases such as multiple sclerosis, rheumatoid arthritis, autism, even allergies as seen in this Wall-Street Journal article.
With the large stage clinical trials patients with both Crohn’s and colitis may get another treatment to use in the ever growing arsenal list of treatments. I am pretty sure if I was born in the 1930’s and had Crohn’s I probably wouldn’t be alive today. Hopefully the FDA (US regulator of drugs) will allow this drug as long as it is proven safe. I would rather have patients and not the FDA decide if the treatment works. Knowledge these days spreads like wildfire. With the internet, e-mail, texting, and other technologies we can transmit information so rapidly ye the FDA feels it should regulate medicine like it were the 1950s. Experimentation is needed in a world full of uncertainty. I think Crohn suffers would agree we would eat worms if it made us feel better.