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.
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