Showing posts with label marijuana. Show all posts
Showing posts with label marijuana. Show all posts

Monday, February 3, 2014

Weekend Links: Drugs Cut Surgery by 60%, Texting, SCD Diet Study, Marijuana Helps Crohn's, JAK1 Study for Crohn's, Golimumab, Fecal Transplant Helps UC and IBS

(Note: I started this post on Saturday however wasn't able to finish it as I saw some more stories to add).

Drugs Cut Need for Surgery By 60% 
     You could say if there is any time to get Crohn's if you had to get it. So in a study that looked at 5,000 patients and looked at the effect of the thiopurine drugs. Azathioprine  for more than 12 months had a 60% reduction within the first 5 years of diagnosis. Thiopurines have been around since the 1970's.  

Texting Helping Children with Crohn's 
      The medical expenses for treating IBD are quite high. Estimates place of IBD is roughly $1.8 billion according to the CCFA. So one way to bring down the costs may be using doctors in order to get patients and doctors to communicate with one another. A clinical trial is taking place at Cincinnati Children's Hospital were an application which uses information from the user and sends it back to the doctor. Patients can respond if they are taking their daily medications and how many times the patient felt sick. The app can track the behavior and get an early idea of when a flare up might occur. The CCFA website has an app called GI Buddy that people can download and track nearly everything related to IBD (bowel movements, what you eat, how you feel, etc). Technology is a no brainer is reducing costs related to not only Crohn's but other chronic illnesses. If you had data on 1,000 different Crohn's patients and ran some analysis on it you could find patterns (what foods help with Crohn's, what foods are likely to cause a flare, what medication works, etc). If patients were able to have their information sent to doctors and doctors could data mine the data to see what patients needed to be responded to first it would make things much more efficient (for both the doctor and patient).
    
Small Study on SCD Diet 
     So in a very small and uncontrolled trial Dr. Ece Mutlu at Rush University looked at 20 patients who adhered to the specific carbohydrate diet (SCD). There is plenty of controversy about this diet. The Crohn's and Colitis Foundation (CCFA) doesn't believe that diet helps. However, if you read internet stories you can find dozens of people who have seemed it helped. This study just looked at the intestinal bacteria. Mutlu claims that some of his own IBD patients have "drastically improved" with mucosal healing and were able to discontinue their immunosuppressants for several years.

Marijuana Treats Crohn's (How Many More Studies Do We Need)
     In a recent study published in the journal Pharmacology showed that cannabis has been shown to help people with cannabis. I have not seen anything published that shows marijuana has a negative impact on Crohn's. This study showed that 70% of patients improved after treatment (this first study was done in 2011). In a follow up study found that 90% of patients had a decrease in their symptoms while 45% of patients had a remission of their Crohn's. Clearly, cannabis should be something that is studied more to see if it can help people with Crohn's. With Colorado allowing people to possess cannabis without any legal trouble it seems perhaps more people will be able to experiment and see if it helps them.

Galapagos Phase 2 Trial For JAK1 Inhibitor for Crohn's 
According to this press release to conduct a phase 2 trial on a JAK1 inhibitor. In the past JAK1 inhibitor as pointed out by Dr. William Sandborn here. Dr. Edward Loftus had a concern about the lipid effects as the drug did increase LDL (bad cholesterol) however Loftus said it wouldn't be a deal breaker. The trial will enroll 180 patients (over 49 different clinic centers around the world) for a 20 week trial.

Golimumab Maintains Clinical Response in Patients With Ulcerative Colitis
     In this phase 3 trial patients were given either 50 mg or 100 mg (subcutaneous injection). There were 464 patients that were enrolled in the trial. Roughly 47% of patients who took the 50 mg treatment were in remission as opposed to the nearly 50% of patients that were in remission in the 100 mg group. 3 patients did die (they were all taking the 100 mg dosage too). Also remember that 3 patients out of 464 is a little more than 1/2 of 1%.

Fecal Transplant Shows More Promise for Ulcerative Colitis and IBS
      So fecal transplant which by the way I believe saved my life is being studied for digestive disease such as Crohn's and ulcerative colitis. All the data I have suggests that fecal transplant would benefit ulcerative colitis patients more than Crohn's patients. Dr. Brandt who has been doing fecal transplants for a long time reported that 63% of his patients (16 patients had IBD-with 14 having UC and 2 having Crohn's) had a lower frequency of flares after they had fecal transplants. The diarrhea also decreased by 56% (8.2 bowel movements to 3.6 bowel movements) after the fecal transplant. Symptoms resolved in 29% of patients and decreased by 43% of patients (21% of patients saw no change). Which means almost 80% of patients saw some benefit to a fecal transplant. Dr. Brandt also looked at fecal transplant for IBS patients and found that 73% of patients had a complete or partial resolution of their symptoms.

Thursday, May 16, 2013

Marijuana 45% Remission in Crohn's Disease and 90% Clinical Response Rate: Why is Marijuana Illegal?




A recent study came out showing that cannabis (marijuana) may help relieve symptoms in people with Crohn’s disease. A complete remission was achieved in 45% of patients while a clinical response was seen in 90% of patients. These numbers would put marijuana on par with Humira or other biologics, however without the possible side effects and for a small fraction of the cost. 

This isn’t the first time there has been this same finding. In 2011 this study was done that 70% of patients using cannabis had a positive effect and possibly may reduce the need for surgery. Nearly 87% of the patients were male. I am curious to know if cannabis would have a different effect in women as opposed to men. Patients with Crohn’s disease often need surgery. However, after they have surgery the risk of having surgery decreases (depending on how severe their Crohn’s is). What is interesting is both of these studies were done in Israel. One problem is that in the United States cannabis is illegal under federal law even though certain states have legalize it. Federal law is superior to state law and at any time people could get thrown in jail for using cannabis.

What is interesting is that 48% of Crohn’s patients have used cannabis during their lifetime according to this study which is only a little higher than the 42% of people in the United States that have used it during their life time.  

Marijuana may not only reduce symptoms in Crohn’s but also multiple sclerosis, chronic pain, rheumatoid arthritis, and other awful disease. The website NORML has a great review of the scientific literature here (and they say potheads are not organized).

The United States should let people with medical issues be able to consume cannabis. Some people claim that smoking cannabis will increase lung cancer. However in one of the largest studies ever done (they looked at people over a 25 year period and couldn’t find any significant increase in risk of lung cancer). Interesting that cannabis may cut the growth of lung cancer. 

What is interesting is that according to a Pew Research poll about 52% of people find that marijuana should be made legal. In 1980, only 24% of people believe it should be legalized which increased to 32% by 2002. Over time I believe this will increase. For people suffering from a chronic illness such as Crohn’s disease, multiple sclerosis, and other awful disease marijuana may help manage these symptoms.  I would be okay with the government legalizing marijuana for medical use which would be much safer than individuals having to go to drug dealers (in states where it is not legal). I personally would not use marijuana until it was okay to do so under federal law. However, if things got really bad I would be open to the possibility. We have to remember that more people die from smoking, drinking, and even eating. Virtually no one dies from using cannabis. What is even worse is that since marijuana is illegal in the United States scientist and researchers can’t study it (why research is done in Israel). The federal government needs to stop harming people and let people use cannabis for medical reasons.  For the people that don’t want people using cannabis I would ask them one question. Have you ever lived with or known someone with a chronic disease?