Feb. 21, 2008 -- Remission from Crohn's disease may be more likely if patients get
immune-suppressing drugs, not steroids, first.
That news, published in the Feb. 23 edition of The Lancet, comes from
a study of Crohn's disease patients in Europe.
The study shows better remission rates when patients started their Crohn's
disease treatment with certain immune-suppressing drugs instead of
"Our study clearly demonstrated that this alternative treatment method was
more effective at inducing disease remission than the conventional method,"
says Brian Feagan, MD, in a news release.
"Not only were patients more likely to get their disease under control, but
they were also spared exposure to steroids -- the extended use of which is
linked with metabolic disease and even increased mortality," says Feagan, who
directs clinical trials at the Robarts Research Institute at Canada's
University of Western Ontario.
Other researchers are testing the same strategy. If their findings,
expected later this year, are in line with those from the European study, "the
treatment algorithm for patients with Crohn's disease will change," sates an
editorial in The Lancet.
The European study included 133 Crohn's disease patients who hadn't started
taking any Crohn's disease medications.
The researchers randomly assigned half of the patients to start Crohn's
disease treatment by taking two immune-suppressing drugs, Remicade and Imuran.
Those patients could later take corticosteroids, if needed.
For comparison, the other patients got standard Crohn's disease treatment,
which involved first taking corticosteroids, then taking Imuran, and finally
The goal of the study was to see which group had better remission rates
without surgery after 26 weeks of treatment and after a year of treatment.
Crohn's Study Results
Remission rates were superior among patients who started treatment with
Remicade and Imuran.
Among those patients, 60% were in remission after 26 weeks of treatment and
nearly 62% were in remission one year after treatment started.
In comparison, about 36% of patients who started with steroid treatment were
in remission after 26 weeks of treatment and 42% were in remission one year
after treatment started.
After the first year of treatment, the two groups had similar remission
rates. Relapse happened later for patients who started with Remicade and
Imuran than those who started with steroids.