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    How Close Are New Celiac Disease Treatments?

    Jefferson Adams

    Celiac.com 04/10/2015 - Of course, a strict gluten free diet is still the only safe and effective treatment for celiac disease. However, new drugs in development, some of which are currently being tested on humans, might allow people with celiac disease to safely eat gluten again, at least in small amounts.

    Photo: CC--Andres Nieto PorrosTo be fair, even if all goes smoothly, it will be a few years at least before we see such treatments on the market. Moreover, even though many early results have been encouraging, none have yet entered safety trials, the final step before Food and Drug Administration approval and commercial availability.

    Drugs currently under trial include an enzyme that splits the protein in wheat that triggers adverse reactions, into smaller harmless products, and another which promises to make the gut less leaky, and thus block potentially toxic substances from triggering inflammation.

    There are several other drugs in earlier stages of development aimed at suppressing the immune response to gluten and preventing intestinal inflammation:

    • ALV003, which will protect people with celiac disease against gut damage from small amounts of gluten.
    • BL-7010 is a novel co-polymer for the treatment of celiac disease, which significantly reduces the immune response triggered by gluten.
    • ImmusanT’s therapeutic vaccine Nexvax2 combines three proprietary peptides that elicit an immune response in celiac disease patients who carry the immune recognition gene HLA-DQ2.
    • Larazotide acetate (AT-1001) is Alba Therapeutics Corporation’s investigational product, a first-in-class tight junction regulator, intended for the treatment of patients with celiac disease.
    • AVX176, from Avaxia Biologics, is an investigational oral antibody drug that is the subject of U.S. composition of matter patent 8,071,101, “Antibody Therapy for Treatment of Diseases Associated with Gluten Intolerance.” The patent, which expires on May 27 2029, provides broad coverage for treating celiac disease using orally administered antibodies produced by Avaxia’s proprietary platform technology [32].
    • ActoGenX is carrying out discovery research in celiac disease with its range of ActoBiotics™, which use Lactococcus lactis as an expression system to locally secrete bio-therapeutics such as cytokines, antibodies, hormones, etc.
    • Chemocentryx’s CCR9, is also known as Traficet-EN, or CCX282B), and was originally intended for patients with moderate-to-severe Crohn’s disease. It has completed one Phase 2 trial in 67 patients with celiac disease.

    Meanwhile, in Europe, Dr. Falk Pharma and Zedira recently announced the start of phase I clinical trials for the drug candidate ZED1227, a direct acting inhibitor of tissue transglutaminase. The small molecule targets the dysregulated transglutaminase within the small intestine in order to dampen the immune response to gluten which drives the disease process.

    Some of these drugs may be taken right before eating gluten, while others might be more effective when taken on a regular schedule. If approved for use as intended, these drugs will likely allow people with celiac disease to eat gluten in small amounts. To my knowledge, there is no drug in current trial phases that is designed to permit unrestricted gluten consumption.

    So, the good news is that the next few years may see commercially available treatments that might actual help people manage celiac disease. The downside for people with celiac disease, at least for now, is that there is no treatment on the horizon that will allow safe, unlimited gluten-consumption. Moreover, there is no hint that a cure is coming anytime soon.

    Still, it’s good to know that researchers are working on providing helpful tools for treating celiac disease.

    Are you looking forward to seeing new treatment options for celiac disease? What kind of benefits should such treatments offer?

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    It would be fabulous if attending a party would not be a total flop because of fear of intake of gluten.

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    Guest bucky

    Posted

    With every action there is a reaction. So it remains to be seen what the after effects of the drugs are and whether they are worth taking or just continuing to avoid gluten continues to be the best MO. We can always remain hopeful. It is a shame however, that one never knows until many years later the devastating effects of some drugs on the body.

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    I'm happy enough to give up bread, pasta, cake etc. entirely. (I'm middle-aged, so can't really eat starches anyway.) Just to be able to eat out with friends without having to go into long explanations and negotiations with servers about the history and provenance of every 20 parts per million would be great!

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    Guest Magister Mundi

    Posted

    Nexvax2 would allow normal consumption of gluten, as the whole point of the treatment is to retroactively correct the body's immune response. In fact, one of the stated objectives on their website is to help people with celiac disease enjoy normal diets again.

     

    You are correct that the rest of them are not intended to allow large amounts of gluten consumption, though. Instead, they would be useful in eliminating the need to worry about cross-contamination - and that's a pretty exciting prospect on its own!

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    Guest D. Johnson

    Posted

    I would be very cautious about taking any of these until it was proven absolutely to have no side effects. There always are some and history has shown some to be deadly.

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    Do you have any info where I can sign up to be in studies for celiac DX in the OKC OK area? I have biopsy proven Celiac and greatly dislike the restrictions on my lifestyle due to it. I would be interested in participating in some studies.

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    Guest Adele

    Posted

    These treatments would be wonderful for my daughter. We have had such a hard time getting her blood levels to normal, despite having a gluten-free household and carefully reading all labels. So this would give me some peace of mind in that regard. Also, with these drugs, we could eat out and order something that's "supposed to be" gluten-free and not have to worry that there might be some cross contamination. It would really make life so much easier!

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    Thanks so much for the update. I attempted to participate in the ALV003 enzyme study but my endoscopy showed my small intestine was too healthy for the study.

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    Guest Gillian

    Posted

    Why on Earth would I want to go back to eating gluten, I feel so much better since giving it up I have also given up most other cereals, and I certainly don't want to be dosing myself up on drugs to be able to eat bagels and cakes again.

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    Guest Cazzy55

    Posted

    I live in UK & was diagnosed with coeliac disease 22 years ago. Initially the Coeliac Society just produced a black ink A5 sheet as a seasonal newsletter - now Coeliac UK produces an impressive full colour 70 page quarterly magazine full of articles, recipes, and advertisements. Ever since I can remember, there was talk of a cure being on the horizon but I fear it's now unlikely to happen. I think the science is there, but a cure will probably be blocked.

    While I am grateful for more awareness & product choice than I could have imagined, there are now so many people with a vested interest in selling us expensive gluten-free alternatives that they are likely to protect their livelihood.

    I also think that while the NHS can fob us off with a diet that largely manages the condition, why would they waste their cash strapped resources paying out for expensive drugs or vaccines when there are so many more pressing needs for their money?

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  • About Me

    Jefferson Adams earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, and science. He previously served as Health News Examiner for Examiner.com, and provided health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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