Sunday, September 15, 2013

Weekend Links: Smoking, Fecal Transplants for IBD, Remicade Generic, Crohnology, and Lasers for IBD

Smoking and Crohn's 
     This article studied people who smoke and use to smoke and found that patients who smoked required more treatment that non-smokers. Smokers were more likely to have strictures, receive steroids, immunosuppressants, or on anti-TNF drugs (this tells me the smokers had more moderate to severe cases of Crohn's). Last year I did a post showing that showed that smokers were more likely to require surgery than non smokers (80% increase actually). Also in that post I mentioned that at 10 years the need for repeat surgery was only 41% for nonsmokers and 70% for smokers. The policy recommendation would be to obviously stop smoking.

Fecal Transplants Treating Bowel Diseases
Early data from a study out of Canada shows that fecal transplant may help people with inflammatory bowel disease (IBD). Canada actually has the highest rate of Crohn's disease in the world. The study plans to look at 120 people (as I write this 60 patients have been treated so far). Patients are using enemas in this trial. Dr. Paul Moayyedi said that some patients have done extremely well so far and one patient was in remission for 6 months. Patient Anna Fernande has been in remission since last fall (she has ulcerative colitis). Personally I believe fecal transplants will help the people with ulcerative colitis more than Crohn's. Perhaps researchers can study why this is the case.

Remicade Going Generic?
It looks like Remicade might be going generic in Europe at least. Drug companies are given a patent to market and sell a particular drug for a decade. However, after this time period a drug then become a generic and usually the cost is substantially less. The generic and the real drug made are on the molecular level however in practice and be a little different. However, with biologics this is trickier to do since you aren't replicating a pill. Inflectra would be what is known as a biosimilar to Remicade. What is interesting is in a trial of people with rheumatoid arthritis patients actually did better under Inflectra (the biosimilar) than Remicade the more expensive drug! Inflectra also showed that is had similar side effects as Remicade. Estimates show that biosimilars could save patients $23 billion by the year 2020. However, one issue is this would only be approved in Europe and not the United States. Perhaps we should have some reciprocal approval program to where if a drug is approved in one country it can be approved in other countries.

Crohnology: Crohn's Patients Helping Other Crohn's Patients
This is a pretty good article on a website Crohnology (which I am a member of) were people with Crohn's and ulcerative colitis discuss what they prescriptions they are on and how they deal with Crohn's. The website is powerful in terms of you can track your health everyday and get a text message that asks how you are doing. Crohnology was founded in 2011 and already has over 4,200 people. Patients helping others is wonderful and there may be important knowledge in Crohnology that researchers could use to better understand this horrible disease.

Laser Peers Through Intestinal Walls
A new laser could be used to help determine if a patients needs a colonoscopy or biopsy. The technology can give doctors a more focused approach to where the biopsy needs to take place instead of guessing.

No comments:

Post a Comment