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Treatment 'could cut out steroids'


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Treatment 'could cut out steroids'


A radical new approach to treating Crohn's disease could avoid exposing patients to the effects of potentially dangerous steroid drugs, say doctors.


The new method relies on combined immunosuppression (CI) therapy. Crohn's, a chronic bowel disorder, is an auto-immune disease in which the body deploys defences against itself.


The traditional "step-up" strategy for managing the disease involves first administering steroids to control the symptoms of stomach pains and bloody diarrhoea. Later, immune system-suppressing drugs are given, followed by an antibody that curbs the inflammatory response at the root of the disease.


Although the approach is often effective, many patients become resistant to or dependent on the drugs used.


Extended use of steroids may result in Cushing's syndrome, a condition marked by rapid weight gain, muscle weakness and skin problems which may lead to high blood pressure, diabetes and heart disease. In some cases, it can shorten life.


The alternative "top-down" therapy addresses the causes of the disease from the start and employs early use of immune-suppressing drugs and an antibody.


A new study published in The Lancet medical journal found that with the "top-down" CI treatment, symptom-treating steroids may never be necessary.


Researchers compared the new and traditional treatments with a trial involving 133 Crohn's patients in Belgium, Holland and Germany.


After 26 weeks, a total of 60% of the patients in the CI group were in remission without having to be treated with steroids. In contrast, only 35.9% of patients in the conventional treatment group were in remission.


Lead author Dr Geert D'Haens, from the Imelda Hospital in Bonheiden, Belgium, said: "This study is a milestone in the management of Crohn's disease."

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I used to be on massive doses of pred off & on for several years, with my first GI, for my Crohn's. Probably lucky I don't also have Cushings.

I'm now on imuran, used as an anti rejection drug for transplant patients. It works so much better for me than pred, and so far no side affects after a few years.


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