Patients with severe bowel disease could benefit from a new drug that can eliminate their distressing symptoms in just three months.
Etrasimod, taken once a day, treats ulcerative colitis by attaching to immune cells and preventing them from mistakenly attacking healthy tissue in the gut lining.
A recent study found that 27 percent of patients who had not responded to any other treatment were in remission after just 12 weeks, and 32 percent were symptom-free after one year.
Ulcerative colitis can be debilitating and cause bloody diarrhea, extreme tiredness, loss of appetite, and weight loss.
It can also trigger symptoms like abdominal pain and indigestion — similar to the more common problem, irritable bowel syndrome (IBS).
Etrasimod, taken once a day, treats ulcerative colitis by attaching to immune cells and preventing them from mistakenly attacking healthy tissue in the gut lining
dr Sami Hoque, a gastroenterologist at Barts Health NHS Trust in London who led the UK arm of the etrasimod trial, described the results as “amazing”.
He added: “When I first started treating ulcerative colitis there were very few options and what we were doing was causing serious side effects. The advantage of etrasimod is that it is very selective and can target stubborn inflammatory cells without affecting the immune system as a whole.
It is an important adjunct to existing treatments for bowel disorders and, unlike other therapies that involve injections, is supplied as a once-daily tablet. This puts the power in the hands of patients, which means they can avoid regular hospital visits.”
Ulcerative colitis is a long-term condition that occurs when the immune system, for reasons not fully understood, goes into overdrive and attacks healthy body tissue in the lining of the colon, or colon, causing inflammation and ulcers. It is one of two main types of inflammatory bowel disease, along with Crohn’s disease.
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The disease affects around 146,000 people in the UK, but experts believe many more may go undiagnosed and up to one in ten people over the age of 50 could have some form of the disease.
Patients can remain symptom-free for months before being struck by a flare-up. During these episodes, some patients also experience painful joints, mouth ulcers, and irritated red eyes. In the most severe cases, they can also suffer from shortness of breath, palpitations and fever.
If colitis is suspected, doctors first take a stool sample to test for a protein called calprotectin — a sign of inflammation in the gut.
If the result is positive, a gastroenterologist will do additional tests to look for physical signs of damage. This usually involves a colonoscopy, where a camera is inserted into the back passage and tissue is cut out for testing.
Initial treatment involves tablets or suppositories containing anti-inflammatory drugs called aminosalicylates. These help manage mild flare-ups, but their effects wear off over time.
Other options include powerful steroids, which reduce inflammation but come with the risk of nasty side effects like acne, mood swings, and diabetes. Drugs that suppress the immune system can also be used, but these can predispose patients to infections.
If these options fail, as they do in 15 percent of cases, surgery to remove the bowel may be the only option.
dr Hoque said, “Etrasimod could be used in combination with existing treatments to boost the body’s defenses and avoid the need for surgery.”
The drug has not yet been approved. However, experts hope that the process will begin later this year.
Romit Zutshi, 42, of Chigwell in Essex, was diagnosed with bowel disease in 2015 and treated with etrasimod as part of the Barts study.
The married father-of-one first went to his GP after seeing blood in his stool and having to go to the bathroom up to eight times a day.
He said: “Not knowing what was going on with me was scary. I started to lose weight and was constantly tired from waking up all night to rush to the bathroom.”
After failing to respond to other medications, he was enrolled in Barts’ etrasimod trial in 2020 and noticed “a drastic improvement.”
He added: “I feel more confident and can live more or less like a normal person. I used to be constantly afraid to be near a toilet when I left the house and couldn’t move properly because I got tired so easily, but that’s no longer a problem.”
ODD SCIENCE: Homemade drug that left the man with fungus in his veins
At the hospital, tests showed the man’s liver and kidneys were failing because the fungus Psilocybe cubensis was growing in his blood
A man developed a life-threatening yeast infection after fungi started growing in his bloodstream.
The 30-year-old American told doctors he was trying to find a way to treat his mental health issues.
After reading that psilocybin, a hallucinogenic compound found in magic mushrooms, could help cancer patients with anxiety and depression, he brewed them into tea and injected it.
In the days that followed, he became nauseous, confused, and began to vomit blood.
At the hospital, tests showed his liver and kidneys were failing due to the Psilocybe cubensis fungus growing in his blood.
According to the Journal Of The Academy Of Consultation-Liaison Psychiatry, the man spent 22 days in the hospital, eight of them in intensive care, with blood filtering and two courses of antibiotics.
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