Showing posts with label Ulcerative colitis. Show all posts
Showing posts with label Ulcerative colitis. Show all posts

Friday, December 20, 2013

#Vedolizumab - Favorable Among FDA for Ulcerative #Colitis & #Crohns

Good News!!  The FDA supports the approval of Vedolizumab for the treatment of Crohn's disease and ulcerative colitis.  The treatment looks extremely promising with a safety profile to be recognized.  
Hey, If I would consider the treatment, it has to have minimal/low risks in regard to serious side effects that a lot of biologics have.  Vedolizumab is looking good in the safety department.
The FDA will make the decision to either approve or deny treatment for use among ulcerative colitis (UC) patients by Feb. 18.  The decision for Crohn’s disease (CD) patients will be several months later around June. 




SILVER SPRING, Md. -- Most members of an FDA advisory committee support approval of the investigational biologic agent vedolizumab for Crohn's disease, as well as supporting an additional indication for ulcerative colitis.


In the closest vote of the Gastrointestinal Drugs and Drug Safety and Risk Management joint advisory committee meeting, the members voted 12-9 in favor of recommending approval of the drug for its Crohn's indication as an induction therapy, while the panel voted 20-0, with one abstention, to greenlight the drug as a maintenance therapy for the condition.
"While the data for Crohn's disease don't appear quite as strong, there does appear to be some efficacy and particularly the 10-week data were compelling," noted panelist Linda Feagins, MD, of the University of Texas Southwestern Medical Center in Dallas. She added that "the need for other treatment for Crohn's disease is great and we see that every day treating our patients, and I feel that doing further trials and holding this for patients will increase costs and delay drug availability."
Because the meeting was delayed by 2 hours due to inclement weather, the panel announced early in its Monday session that it would skip a formal vote on the ulcerative colitis indication, citing overwhelming evidence in its favor.
Vedolizumab's manufacturer, Takeda Pharmaceuticals, submitted the drug for approval for the Crohn's disease and ulcerative colitis patient population who had moderate to severely active disease and who were inadequately treated with, did not respond to, or were intolerant of convention therapy or a tumor necrosis factor-alpha antagonist.
Phase III trial data showed the drug was effective in ulcerative colitis patients, but only one of two trials showed drug efficacy at 6 weeks for Crohn's disease. However, data presented during the panel meeting out to 52 weeks of treatment showed significant improvements in remission rates among those who received drug treatment for 4 and 8 weeks.


Another issued raised prior to the panel discussion were concerns over risks for progressive multifocal leukoencephalopathy (PML), a rare but potentially fatal demyelinating condition that can occur in patients receiving natalizumab (Tysabri) and other immunosuppressive medications and who are infected with JC virus.
However, in the only unanimous vote of the session, all 21 panelists voted Yes that Takeda had sufficiently accounted for the risk of PML to support approval; Takeda said that although no cases had occurred during phase III studies, the company would still conduct post-market research and include a warning in its packaging. The panel routinely supported its vote with praise for the risk mitigation strategy and post-market research.
Another vote concerned whether concomitantly administered immunosuppressants should be limited to a specific duration. The panel voted 19-1, with one abstention, against such a limit.
For each condition, the panel voted on whether benefits outweighed risks to support approval of the drug in patients who failed steroid, immunosuppressive, or TNF-alpha antagonists; immunosuppressants or TNF-alpha antagonists; or neither. The vote for ulcerative colitis favored treatment for all conditions, with 14 voting for the first option, seven voting for the second, and none voting for the third. Similarly for Crohn's disease, 14 favored the first option, six favored the second, and one panelist favored neither.
Regarding the vote for the ulcerative colitis indication, committee member Elaine Morrato, DrPH, of the Colorado School of Public Health in Aurora, voted for the least restrictive option, but noted that "the products should be effective, but I worry that a specific requirement for failure of immunosuppressant or anti-TNF would be overly burdensome when you're translating this into clinical practice," adding that she "would rather have those discussions left with the patient and the provider."
Those favoring the middle option preferred a bottom-up approach while waiting for additional data on which patient populations would be best served by the drug with the least risk.
The agency is not required to follow the advice of its advisory committees, though it often does.

Wednesday, October 23, 2013

Qing Dai, A Chinese #Herb & #Acupuncture Clear Ulcerative #Colitis - Good Read

This is good news for people looking for an alternative therapy option for hard to treat cases of ulcerative colitis (UC).  Read the case about the man with UC under the Clinical Highlight section of this article.  It's hopeful in my opinion.  

My $0.02 - It's nice to see herbal forms of medicine being tested clinically and seeing the results published in known journals.  I'd like to see a larger study though.  The 1st thing a skeptic would point out about this research is the size of the study.  It's way too small, but not small enough to say that the results don't show significance.  There just needs to be larger clinical studies being conducted to make an impact.  The more participants that have a beneficial result, the more noteworthy the findings will be.  Size matters in this case, especially since TCM and naturopathic medicine are not recognized as effective in the medical community........ still.  You would think that by now alternative approaches of treating diseases would be accepted more than they are.  Unfortunately the pharmaceutical presence is all we can see and hear because the industry's ability to market their drugs.  

When we are faced with a choice in respects to treatment (alternative approach vs. conventional), we have to take into consideration the two types of areas of medicine and the facts surrounding them.  This part is simple.  Large markets get more exposure.  More exposure leads to something being talked about more, used more, and becoming the popular choice that is opted for the masses. Who has never heard of Cymbalta, Humira, Lunesta?  If you have a tv, you've heard of at least one of these drugs.  Are the drugs that we hear about on a constant basis a better choice than the little guy that doesn't have the multimillion dollar advertising budget? You make that decision.   Research and figure it out.


New research finds a very powerful Traditional Chinese Medicine (TCM) herb effective in resolving ulcerative colitis. The patients examined in the study published in the World Journal of Gastroenterology suffered from intractable ulcerative colitis and were unresponsive to conventional drug therapy. After use of the herbal medicine, 6 of the 7 patients in the study were able to completely discontinue the use of anti-inflammatory medications. This included the use of aminosalicylates, corticosteroids and azathioprine. Endoscopy and symptomatic responses showed everything from significant clinical improvements to a complete resolution of the condition.
Herbal Powder
The patients orally self-administered 1 gram of Qing Dai (Indigo Naturalis) powder, 2 times per day for 4 months. The results of the herbal program demonstrated significant clinical and objective improvements such that 6 of the 7 patients completely discontinued the use of prednisolone, a corticosteroid used to control ulcerative colitis. The researchers examined Qing Dai to learn more about its effective mechanisms of action. Using electron spin resonance, they discovered that Qing Dai has potent hydroxl radical scavenging activity. This discovery prompted the researchers to recommend further investigation into the mechanisms of Qing Dai’s anti-inflammatory effects.

This research coincides with other recent research demonstrating that acupuncture and herbal medicine are effective in the clearing of chronic ulcerative colitis. Published in the Clinical Journal of Chinese Medicine, the study showed that a combination of herbal enemas consisting of Ku Shen and Bai Tou Weng combined with an acupuncture treatment regime was significantly more effective than taking antibiotics for resolving ulcerative colitis.
The Qing Dai study examined the oral administration of Qing Dai in its powdered form. Qing Dai has received a great deal of attention in modern research. One recent research study found that I3M, synthesized from the indirubin found in Qing Dai, downregulates cancerous tissues when applied topically to oral cancer. This shows great potential for the treatment of oral cancer. Historically, TCM documents Qing Dai as an important herb in the treatment of ulcers in the mouth and tongue. TCM also documents the use of Qing Dai as a topical paste for the treatment of acne and topical ointment for the treatment psoriasis. HealthCMi recently published instructions on how to prepare the anti-acne topical paste in its blog section. Visit the Healthcare Medicine Institute's blog to learn more.
The I3M study cited the TCM formula Dang Gui Long Hui Wan as an historically important herbal compound for the treatment of chronic myelocytic leukemia. Many sources include Qing Dai as one of the ingredients in this formula that contains Dang Gui, Long Dan Cao, Zhi Zi, Huang Lian, Huang Bai, Huang Qin, Lu Hui, Da Huang, Qing Dai, Mu Xiang, She Xiang and Sheng Jiang. The researchers suggest that the indigo dye found in Qing Dai is partially responsible for the herbal formula’s efficaciousness given the modern research demonstrating that indirubin powerfully inhibits several types of human cancer cells. The Qing Dai researchers noted that modern studies demonstrate that indirubin has anti-inflammatory effects by suppressing interferon-alpha, interleukin-6 and nuclear factor. They added that Qing Dai has been shown to exert anti-inflammatory “effects on human neutrophils based on its ability to suppress superoxide generation.”
Clinical Highlight
The Qing Dai study highlighted specific clinical results of its participants. One patient vignette was of a man suffering from ulcerative colitis with hematochezia, the passage of fresh blood through the anus. This patient had taken antibiotics and prednisolone to control the hematochezia. However, he was unable to reduce the dosage of prednisolone without the return of hematochezia. Over time, the patient needed to increase the drug dosages to maintain clinical results and he showed no clinical improvements in his baseline condition. After 3 years, he began the Qing Dai treatments and after one month the hematochezia resolved completely. Objective testing also showed a marked decrease in serum C-reactive protein levels. The patient was able to discontinue the use of all drugs. Endoscopy revealed that his ulcers completely disappeared. A follow-up confirmed that the therapeutic effect of Qing Dai therapy lasted for more than 2 years.
The researchers note that other related research finds important clinical results from the use of Qing Dai. Yuan, et al, discovered that Qing Dai enemas are clinically effective for the treatment of chronic hemorrhagic radiation proctitis. Given the recent research combining acupuncture with herbal medicine demonstrating that enemas of Ku Shen combined with Bai Tou Weng are effective for the treatment of ulcerative colitis, it may be consistent that adding Qing Dai to the enema will enhance its therapeutic effects.
Distinct from Qing Dai used as a one herb formula for the treatment of chronic ulcerative colitis is its use within herbal formulas within the scope of Traditional Chinese Medicine (TCM). Differential diagnostics within the TCM system recognise Qing Dai’s appropriate application for this biomedically defined disorder in cases of Heat in the Blood, Damp Heat and Heat and Toxins. However, some clinical presentations of chronic ulcerative colitis may be due to cases of cold and deficiency. In these instances, herbal medicines with very different biological functions may exert more effective clinical actions for the treatment of chronic ulcerative colitis.
How serious is this research? Below is an image of three colon wall sections that are inflamed due to chronic ulcerative colitis. The image speaks to the importance of integrating TCM herbal medicine into the healthcare system.
A close-up of a colon wall. Colon wall inflamed from ulcerative colitis
References:
Suzuki, Hideo, Tsuyoshi Kaneko, Yuji Mizokami, Toshiaki Narasaka, Shinji Endo, Hirofumi Matsui, Akinori Yanaka, Aki Hirayama, and Ichinosuke Hyodo. "Therapeutic efficacy of the Qing Dai in patients with intractable ulcerative colitis." World journal of gastroenterology: WJG 19, no. 17 (2013): 2718.
Clinical observation on treating chronic ulcerative colitis with retention enema by Baitouweng Kushen decoction and acupuncture, Clinical Journal of Chinese Medicine, 1674-7860, 2013.
Lo W-Y, Chang N-W (2013) An Indirubin Derivative, Indirubin-3′-Monoxime Suppresses Oral Cancer Tumorigenesis through the Downregulation of Survivin. PLoS ONE 8(8): e70198. doi:10.1371/journal.pone.0070198.Editor: A. R. M. Ruhul Amin, Winship Cancer Institute of Emory University, United States of America.
Yuan G, Ke Q, Su X, Yang J, Xu X. Qing Dai, A traditional Chinese medicine for the treatment of chronic hemorrhagic radiation proctitis. Zhong De Linchuang Zhongliuxue Zazhi. 2009;8:114–116.
Lin YK, Leu YL, Huang TH, Wu YH, Chung PJ, Su Pang JH, Hwang TL. Anti-inflammatory effects of the extract of indigo naturalis in human neutrophils. J Ethnopharmacol. 2009;125:51–58.

Tuesday, October 1, 2013

Vedolizumab, A New Treatment for Ulcerative Colitis & Crohn's Disease Looks Promising - Info & Clinical Trial Included

Vedolizumab, a potentially new treatment for UC and Crohn's disease is being fast tracked for review by the FDA.  The BLA (biologics license application) will give priority review to the ulcerative colitis application and standard review to the Crohn's disease application.
The part of the clinical trial that is most important to me is the said adverse effects that were found in the patients who participated in the study.  Based on the concluding trial results, the adverse effects of the drug is said to be the same as the placebo.  That's great news.  I'm going to continue to watch this drug for new updates and news pertaining to safety. So far, this new treatment by Takeda Pharmaceuticals looks promising.
I have also included the clinical trial abstract below.  

On Sept. 4, Takeda Pharmaceutical Company Ltd., announced that it received priority review status from the FDA for its drug vedolizumab, an investigational antibody for the treatment of adults with moderately to severely active Crohn’s disease (CD) and ulcerative colitis (UC). Takeda submitted a biologics license application (BLA) to the FDA in June for the treatment of CD and UC; the UC application will receive priority review, and the application for CD will be reviewed under the standard timeline.

The FDA grants priority review status for drugs that are designed to treat a serious condition, and that if approved, would provide a significant improvement in safety or effectiveness. Priority review designation allows for an eight-month review period compared with the standard 12-month review.
“The need to seek new treatment options is well recognized,” said William J. Sandborn, MD, chief, Division of Gastroenterology, and professor of medicine, University of California, San Diego School of Medicine, in a press statement. “Vedolizumab has demonstrated the potential to be another possible treatment option for people with moderately to severely active CD and UC.”
Vedolizumab is a humanized monoclonal antibody that specifically antagonizes α4β7 integrin and inhibits it from binding to its target receptor, mucosal addressin cell adhesion molecule-1 (MAdCAM-1). MAdCAM-1 is preferentially expressed on blood vessels and lymph nodes of the gastrointestinal tract. It interacts with α4β7 integrin, which is expressed on a subset of circulating white blood cells, to mediate the inflammatory process in patients with CD and UC.
Takeda’s BLA submission is supported by four Phase III clinical studies—GEMINI I, II and III, and GEMINI LTS (Long-Term Safety)—which comprise the GEMINI StudiesTM, a clinical program designed to investigate the efficacy and safety of vedolizumab in clinical response and remission in patients with moderate to severe CD and UC. Patients enrolled in the studies failed at least one conventional therapy for inflammatory bowel disease, including corticosteroids, immunomodulators and/or a tumor necrosis factor–alpha antagonist. The results of the Phase III studies of vedolizumab in patients with CD and UC were published recently in the New England Journal of Medicine (Sandborn WJ et al. N Engl J Med2013;369:711-721 and Feagan BG et al. N Engl J Med 2013;369:699-710, respectively).
According to Takeda, vedolizumab has been studied in 2,700 patients in nearly 40 countries, making it the largest Phase III clinical trial program to date to simultaneously evaluate CD and UC. GEMINI LTS is an ongoing, open-label, long-term safety study of vedolizumab and is designed to collect data on the occurrence of important clinical safety events resulting from the administration of vedolizumab.
—Based on a press release from Takeda Pharmaceutical Company Ltd.

Clinical Trial - PUBMED.gov

  2013 Aug 22;369(8):699-710. doi: 10.1056/NEJMoa1215734.

Vedolizumab as induction and maintenance therapy for ulcerative colitis.

Source

Robarts Clinical Trials, Robarts Research Institute, and Department of Medicine, University of Western Ontario, London, Canada. bfeagan@robarts.ca

Abstract

BACKGROUND:

Gut-selective blockade of lymphocyte trafficking by vedolizumab may constitute effective treatment for ulcerative colitis.

METHODS:

We conducted two integrated randomized, double-blind, placebo-controlled trials of vedolizumab in patients with active disease. In the trial of induction therapy, 374 patients (cohort 1) received vedolizumab (at a dose of 300 mg) or placebo intravenously at weeks 0 and 2, and 521 patients (cohort 2) received open-label vedolizumab at weeks 0 and 2, with disease evaluation at week 6. In the trial of maintenance therapy, patients in either cohort who had a response to vedolizumab at week 6 were randomly assigned to continue receiving vedolizumab every 8 or 4 weeks or to switch to placebo for up to 52 weeks. A response was defined as a reduction in the Mayo Clinic score (range, 0 to 12, with higher scores indicating more active disease) of at least 3 points and a decrease of at least 30% from baseline, with an accompanying decrease in the rectal bleeding subscore of at least 1 point or an absolute rectal bleeding subscore of 0 or 1.

RESULTS:

Response rates at week 6 were 47.1% and 25.5% among patients in the vedolizumab group and placebo group, respectively (difference with adjustment for stratification factors, 21.7 percentage points; 95% confidence interval [CI], 11.6 to 31.7; P<0 .001="" 41.8="" 44.8="" 4="" 52="" 8="" and="" at="" ayo="" clinic="" clinical="" continued="" every="" in="" no="" of="" patients="" receive="" remission="" score="" subscore="" to="" vedolizumab="" week="" weeks="" were="" who="">1), as compared with 15.9% of patients who switched to placebo (adjusted difference, 26.1 percentage points for vedolizumab every 8 weeks vs. placebo [95% CI, 14.9 to 37.2; P<0 .001="" 17.9="" 29.1="" 40.4="" 4="" adverse="" and="" ci="" events="" every="" for="" frequency="" groups.="" in="" of="" p="" percentage="" placebo="" points="" similar="" the="" to="" vedolizumab="" vs.="" was="" weeks="">

CONCLUSIONS:

Vedolizumab was more effective than placebo as induction and maintenance therapy for ulcerative colitis. (Funded by Millennium Pharmaceuticals; GEMINI 1 ClinicalTrials.gov number, NCT00783718.).
PMID:
 
23964932
 
[PubMed - indexed for MEDLINE]


http://www.ncbi.nlm.nih.gov/pubmed/?term=23964932

Monday, September 23, 2013

NEW TREATMENT OPTION - SIMPONI® Receives Approval in UK for the Treatment of Ulcerative Colitis/ #UC

I just read that today Simponi was approved for the treatment of ulcerative colitis in the UK.  This may be a successful treatment option for people that have not been able to obtain remission with mainstream treatments for the disease.  Some people, like myself, have tried them all with no improvement.  It's very frustrating to hit that wall and run out of effective treatments..... actually, safe effective treatments.  If you just can't seem to get the inflammation and toll taking symptoms under control and you've taken into consideration the risks vs. the benefits, some people may find relief with this new drug.  This particular article does include the potential health risks from TNF-blocking therapies, toward the end of the article.  

If you are considering Simponi (or any immunesuppressing drug), please know everything about it before agreeing to the treatment.   Everyone should know what the risks are versus the benefits before beginning any kind of treatment like this.  Your doctor will not tell you everything about these drugs and from personal experience, most doctors down play the risks and don't even look at  family history/genetics when deciding if these treatments are appropriate.   It's disturbing when you know that the information you completed for your file, (providing family history) and screams *HIGH RISK*, and the doctor recommends the treatment anyway.   Sadly, it's probably because the doctor didn't even scan over this little piece of information that says a lot.  Another reason is because TNF-blocking therapies have become the conventional prescribing treatments for IBD now, despite their high side-effect profile.   

Personally, I would never consider being treated with an immune suppressing drug of this potency because of the numerous possible health problems that could result.  It's not worth it to me to put my entire body at risk of developing something life altering (conditions worse than what I'm treating) with the awareness that there are life changes that I can make that will encourage healing and repair of my digestive tract.  It takes determination to make the changes that are necessary and it takes longer to heal, but in my opinion, it's my overall health that I care about.  You will get there, I did.

Most doctors will say that diet is not a big contributor to IBD however,  it infact makes a huge difference in respects to your success with reaching remission. What foods you choose to eat WILL affect your health negatively or positively, it's a decision that you can control that will have a significance on your overall quality of life.  If you struggle with diet and need some guidance, send me an email.  Years ago I was clueless about what to eat and what not to eat.   I was blessed to have connected with a few very knowledgeable people that helped me in the area of diet.  I'm always willing to help people that need some support and suggestions, so feel free to contact me if you need some support.     



-- First and Only Subcutaneous Biologic Treatment Administered Every Four Weeks Approved for Ulcerative Colitis


LEIDEN, The NetherlandsSept. 23, 2013 /PRNewswire/ -- Janssen Biologics B.V. ("Janssen") announced today that the European Commission has approved SIMPONI® (golimumab) for the treatment of moderately to severely active ulcerative colitis (UC) in adult patients who have had an inadequate response to conventional therapy including corticosteroids and 6-mercaptopurine (6-MP) or azathioprine (AZA), or who are intolerant to or have medical contraindications for such therapies.  The European Commission approval follows a positive opinion by the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) in July 2013 recommending the use of SIMPONI.  UC, a chronic inflammatory bowel disease (IBD) affecting 1.1 million individuals in Europe[1]  and 2.5 million people worldwide,[2]  is marked by inflammation and ulceration of the colonic mucosa, which may lead to bloody stools, severe diarrhea and frequent abdominal pain.
"The European Commission approval of SIMPONI for the treatment of moderately to severely active ulcerative colitis is an important milestone for patients and the gastroenterology community," said Jerome A. Boscia, M.D., Vice President, Head of Immunology Development, Janssen Research & Development, LLC.  "SIMPONI demonstrated efficacy across multiple disease parameters in the study of this devastating inflammatory bowel disease according to the PURSUIT clinical development program, which represents the largest conducted for an anti–tumor necrosis factor-alpha therapy in the treatment of ulcerative colitis."
SIMPONI is the first and only subcutaneous anti–tumor necrosis factor (TNF)-alpha treatment administered as an every-4-week maintenance therapy for UC.  For patients with a body weight less than 80 kg, SIMPONI is given subcutaneously as an initial dose of 200 mg, followed by 100 mg at week 2 and then 50 mg every 4 weeks thereafter.  For patients with a body weight greater than or equal to 80 kg, SIMPONI is given as an initial dose of 200 mg, followed by 100 mg at week 2 and then 100 mg every 4 weeks thereafter. 
Data from the clinical development Program of Ulcerative Colitis Research Studies Utilizing an Investigational Treatment (PURSUIT), which served as the basis for European Commission approval, showed that induction treatment with SIMPONI induced clinical response, clinical remission, mucosal healing and improved quality of life as measured by the inflammatory bowel disease questionnaire (IBDQ) in patients with moderately to severely active UC.  Further, per the European Commission–approved Summary of Product Characteristics, maintenance therapy with SIMPONI maintained clinical response through week 54.  In addition, in patients who had initially responded to induction therapy with SIMPONI, more SIMPONI-treated patients demonstrated sustained clinical remission and mucosal healing at weeks 30 and 54 compared with patients in the placebo group.[3]
About PURSUITThe Program of Ulcerative Colitis Research Studies Utilizing an Investigational Treatment (PURSUIT) included Phase 3 multicenter, randomised, double-blind, placebo-controlled studies designed to evaluate the safety and efficacy of subcutaneous induction and every-4-week maintenance regimens of SIMPONI in adults with moderately to severely active UC. All trial patients had failed to respond to or tolerate treatment with 6-MP, AZA, corticosteroids and/or 5-aminosalicylate (5-ASA), or were corticosteroid dependent.  Study participants were naive to treatment with TNF inhibitors and had a baseline Mayo score between 6 and 12 and an endoscopic subscore of 2 or more.  The Mayo score is a 12-point clinical assessment and colonoscopy-based measure of disease activity, which assesses improvement in symptoms based on rectal bleeding, endoscopic findings, stool frequency and a physician's global assessment.
The induction trial (PURSUIT-SC) had an adaptive design with a Phase 2 dose-finding portion, followed by a Phase 3 dose-confirming component.  The primary endpoint was clinical response at week 6.  Secondary endpoints at week 6 included clinical remission and mucosal healing (Mayo endoscopy score of 0 or 1).  Overall, 1,065 patients were treated in the study; 761 of these patients were randomised into the Phase 3 component of the study.
Patients responding to induction treatment with SIMPONI were eligible to be randomised in the Phase 3 PURSUIT-Maintenance study.  The primary endpoint in this study was maintenance of clinical response through week 54, and secondary endpoints included clinical remission and mucosal healing (Mayo endoscopy score of 0 or 1 at both weeks 30 and 54).
The safety results of SIMPONI observed in the PURSUIT studies were consistent with the known safety profile of SIMPONI in labeled rheumatologic indications.  For more information regarding the safety profile for SIMPONI, please see "Important Safety Information" below.
About Ulcerative Colitis Ulcerative colitis (UC), a chronic inflammatory bowel disease (IBD) affecting 1.1 million individuals in Europe[1] and 2.5 million worldwide,[2] is marked by the inflammation and ulceration of the colonic mucosa, or innermost lining, which may lead to bloody stools, severe diarrhea and frequent abdominal pain.[4]  Tiny open sores, or ulcers, form on the surface of the lining, where they bleed and produce pus and mucus.[4]  Symptoms of the disease may lead to loss of appetite, subsequent weight loss and fatigue.[4]  On average, people are diagnosed with UC in their mid-30s, but the disease can occur at any age.[4] As many as 30 percent of people living with UC will require surgery at some point in their life.[5]  UC is a chronic disease, and there is no cure.  Although progress has been made in IBD research, researchers do not know what causes this disease.[4] 
About SIMPONI® (golimumab)SIMPONI is a human monoclonal antibody that targets and neutralises excess tumor necrosis factor (TNF)-alpha, a protein that when overproduced in the body due to chronic inflammatory diseases can cause inflammation and damage to bones, cartilage and tissue.  SIMPONI is approved in 70 countries for rheumatologic indications, including the European Union (EU), where SIMPONI received European Commission approval in October 2009 for the treatment of moderate-to-severe, active rheumatoid arthritis in combination with methotrexate, for the treatment of active and progressive psoriatic arthritis alone or in combination with methotrexate and for the treatment of severe, active ankylosing spondylitis.  In September 2013, SIMPONI received European Commission approval for the treatment of moderately to severely active ulcerative colitis.  SIMPONI is available either through the SmartJect® autoinjector/prefilled pen or a prefilled syringe as a subcutaneously administered injection.  For more information about SIMPONI in the EU, visit www.SIMPONI.eu.  
Janssen Biotech, Inc. discovered and developed SIMPONI and markets the product in the United States.  The Janssen Pharmaceutical Companies market SIMPONI in Canada, Central and South America, the Middle EastAfrica and Asia Pacific. 
In EuropeRussia and Turkey, Janssen Biotech, Inc. licenses distribution rights to SIMPONI to Schering-Plough (Ireland) Company, a subsidiary of Merck & Co., Inc. 
In JapanIndonesia and Taiwan, Janssen Biotech, Inc. licenses distribution rights to SIMPONI to Mitsubishi Tanabe Pharma Corporation and has retained co-marketing rights in those countries. 
For further information about SIMPONI, please consult the relevant official product information applicable to that country location.
Important Safety Information In the European Union, SIMPONI is contraindicated in patients with active tuberculosis, severe infections such as sepsis, opportunistic infections, in patients with moderate or severe heart failure (NYHA Class III/IV), as well as in patients who are hypersensitive to SIMPONI or any of its excipients.  Serious infections, including sepsis, pneumonia, tuberculosis (TB), invasive fungal and other opportunistic infections have been observed with the use of TNF antagonists including SIMPONI.  Some of these infections have been fatal. SIMPONI should not be given to patients with a clinically important, active infection.  Caution should be exercised when considering the use of SIMPONI in patients with a chronic infection or a history of recurrent infection.  Patients must be monitored closely for infections including TB before, during and after treatment with SIMPONI.  If a patient develops a new serious infection or sepsis, SIMPONI therapy should be discontinued and appropriate antimicrobial therapy should be initiated until the infection is controlled.  Patients should be advised of, and avoid exposure to, potential risk factors for infection as appropriate.  For patients who have resided in or traveled to regions where invasive fungal infections such as histoplasmosis, coccidioidomycosis, or blastomycosis are endemic, the benefits and risks of SIMPONI treatment should be carefully considered before initiation of SIMPONI therapy.  All patients must be evaluated for the risk of TB, including latent TB, prior to initiation of SIMPONI.  If active TB is diagnosed, SIMPONI must not be initiated.  If latent TB is suspected or diagnosed then the benefit/risk balance of SIMPONI treatment should be considered.  Treatment of latent tuberculosis infection should be initiated prior to therapy with SIMPONI.  Antituberculosis therapy prior to initiating SIMPONI should also be considered in patients who have several or highly significant risk factors for tuberculosis infection and have a negative test for latent tuberculosis.  Patients receiving SIMPONI should be monitored closely for signs and symptoms of active tuberculosis during and after treatment, including patients who tested negative for latent tuberculosis infections. 
The use of TNF blocking agents including SIMPONI has been associated with reactivation of hepatitis B virus (HBV) in patients who are chronic carriers of the virus.  Some of these cases have been fatal.  Patients should be tested for HBV infection before initiating treatment with Simponi.  Carriers of HBV who require treatment with Simponi should be closely monitored during treatment with, and for several months following discontinuation of SIMPONI.  In patients who develop HBV reactivation, SIMPONI should be discontinued.
Lymphomas and leukemia have been observed in patients treated with TNF blocking agents, including SIMPONI.  The incidence of non-lymphoma malignancies was similar to controls, and lymphoma is seen more often than in the general population.  The potential role of TNF-blocking therapy in the development of malignancies is not known.  Based on an exploratory clinical trial in patients with COPD using another anti-TNF agent, caution should be exercised when using any TNF-blocking therapy in COPD patients, as well as in patients with an increased risk for malignancy due to heavy smoking.  Rare post-marketing cases of hepatosplenic T-cell lymphoma (HSTCL) have been reported in patients treated with other TNF-blocking agents.  This rare type of T-cell lymphoma has a very aggressive disease course and is usually fatal. 
Malignancies, some fatal, have been reported among children, adolescents and young adults (up to 22 years of age) treated with TNF-blocking agents (initiation of therapy ≤ 18 years of age) in the post marketing setting. A risk for the development of malignancies in children and adolescents treated with TNF-blockers cannot be excluded.
It is not known if SIMPONI treatment influences the risk for developing dysplasia or colon cancer.  All patients with ulcerative colitis who are at increased risk for dysplasia or colon carcinoma, or who had a prior history of dysplasia or colon carcinoma should be screened for dysplasia at regular intervals before therapy and throughout their disease course.
Melanoma has been reported in patients treated with TNF-blocking agents, including Simponi. Periodic skin examination is recommended, particularly for patients with risk factors for skin cancer.
Worsening and new onset congestive heart failure (CHF) and increased mortality due to CHF have been reported with another TNF blocker.  SIMPONI has not been studied in patients with CHF.  SIMPONI should be used with caution in patients with mild heart failure and must be discontinued if new or worsening symptoms of heart failure appear. 
TNF-blocking agents, including SIMPONI, have been associated in rare cases with new onset or exacerbation of demyelinating disorders, including multiple sclerosis.  The benefits and risks of anti-TNF treatment should be carefully considered before initiation of SIMPONI therapy in patients with pre-existing or recent onset of demyelinating disorders. 
There is limited safety experience of SIMPONI treatment in patients who have undergone surgical procedures, including arthroplasty.  A patient who requires surgery while on SIMPONI should be closely monitored for infections, and appropriate actions should be taken. 
The possibility exists for TNF-blocking agents, including SIMPONI, to affect host defenses against infections and malignancies.  Treatment with SIMPONI may result in the formation of auto-antibodies and, rarely, in the development of a lupus-like syndrome. 
There have been postmarketing reports of pancytopenia, leukopenia, neutropenia, aplastic anemia, and thrombocytopenia in patients receiving TNF blockers.  Cytopenias including pancytopenia, have been infrequently reported with SIMPONI in clinical trials.  Discontinuation of SIMPONI should be considered in patients with significant hematologic abnormalities. 
The concurrent administration of TNF-antagonists with anakinra or abatacept is not recommended.  Concurrent administration has been associated with increased infections, including serious infections without increased clinical benefit.  The concomitant use of Simponi with other biological therapeutics used to treat the same conditions as Simponi is not recommended because of the possibility of an increased risk of infection, and other potential pharmacological interactions.  Patients should continue to be monitored when switching from one biologic to another.
Patients treated with SIMPONI may receive concurrent vaccinations, except for live vaccines.  In postmarketing experience, serious systemic hypersensitivity reactions have been reported following Simponi administration.  Allergic reactions may occur after first or subsequent administration of SIMPONI.  If an anaphylactic reaction or other serious allergic reactions occur, administration of SIMPONI should be discontinued immediately and appropriate therapy initiated. 
The needle cover on the syringe in the pre-filled pen is manufactured from dry natural rubber containing latex, and may cause allergic reactions in individuals sensitive to latex.  SIMPONI also contains sorbitol; patients with rare hereditary problems of fructose intolerance should not take SIMPONI. 
Patients should be given detailed instructions on how to administer SIMPONI.  After proper training, patients may self inject if their physician determines that this is appropriate.  The full amount of SIMPONI should be administered at all times.   
Women of childbearing potential must use adequate contraception to prevent pregnancy and continue its use for at least 6 months after the last SIMPONI treatment.  Women must not breast feed during and for at least 6 months after SIMPONI treatment.
The most common adverse drug reaction reported in the controlled portion from clinical trials was upper respiratory tract infection (12.6 percent of SIMPONI-treated patients compared with 10.7 percent in control-treated patients).  In the controlled periods of pivotal trials, 5.1 percent of SIMPONI-treated patients had injection site reactions compared with 2.0 percent in control-treated patients.  The majority of the injection site reactions were mild and moderate, and the most frequent manifestation was injection site erythema.
The SIMPONI Patient Alert Card provides safety information to the patient.  It should be given and explained to all patients before treatment.  Patients must show the Alert Card to any doctor involved in his/her treatment, during and up to 6 months after SIMPONI treatment.
For complete EU prescribing information, please visit www.ema.europa.eu.
About Janssen Biologics B.V. and Janssen Research & Development, LLCAt Janssen, we are dedicated to addressing and solving some of the most important unmet medical needs of our time in oncology, immunology, neuroscience, infectious diseases and vaccines, and cardiovascular and metabolic diseases. Driven by our commitment to patients, we develop innovative products, services and healthcare solutions to help people with serious diseases throughout the world.  Beyond its innovative medicines, Janssen is at the forefront of developing education and public policy initiatives to ensure patients and their families, caregivers, advocates and healthcare professionals have access to the latest treatment information, support services and quality care.
Janssen Biologics B.V. and Janssen Research & Development, LLC are two of the Janssen Pharmaceutical Companies of Johnson & Johnson.  Please visit www.janssen.com for more information.
References:
[1]     European Federation of Crohn's and Ulcerative Colitis Associations. What is IBD? http://www.efcca.org/index.php/about-efcca/what-are-ibd. Accessed August 14, 2013.
[2]     World IBD Day. About us. http://worldibdday.org/aboutus.html. Accessed August 6, 2013.
[3]     SIMPONI [Summary of Product Characteristics]. Leiden, The Netherlands: Janssen Biologics B.V.; September 2013.
[4]     Crohn's & Colitis Foundation of America. What is ulcerative colitis? http://www.ccfa.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis. Accessed August 6, 2013. 
[5]     Crohn's & Colitis Foundation of America. Colitis treatment options. http://www.ccfa.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis/colitis-treatment-options.html. Accessed August 6, 2013.
SOURCE Janssen Biologics B.V.
http://www.prnewswire.co.uk/news-releases/simponi-receives-european-commission-approval-for-treatment-of-moderately-to-severely-active-ulcerative-colitis-224821222.html

Sunday, August 11, 2013

Co-pay Assistance Programs List | UCERIS & Other Prescriptions

When I first heard of Uceris, it reminded me of the drug Entocort.  Both treatments are very similar - same active ingredient and both are time-released.  The only difference is that Uceris is released in the colon vs Entocort, which is released in the small intestine.  That explains why Entocort wasn't effective when I tried it years ago. Most of my inflammation at that time was located in the large intestine and part of the small intestine (terminal ileum - the last area of the small intestine connecting to the large intestine). 
People with Ulcerative Colitis experience inflammation specific to the large intestine/colon.  
Hopefully this medication will help with healing the lowest part of my colon - the most difficult area to heal from what I have read.   Maybe this could be an option that some of you may want to try as a safer treatment option .  


  • IMPORTANT NOTE TO MENTION - This form of steroid does not produce the horrible side-effects that come with oral prednisone (aka - satans tic-tacs).  We all know what those side effects are if we have ever taken prednisone.  Due to the time-release of the drug at it's target location, very little of the medication is released into the bloodstream.  This is a very good thing!! 


What it says about Uceris @ www.uceris.com

About UCERIS

UCERIS (u-SAIR-us) is a medicine used to treat active, mild to moderate ulcerative colitis (UC). It's for people experiencing UC symptoms or a flare-up who are trying to reach remission, a period of time without symptoms.
UCERIS is a different kind of steroid designed specifically to treat UC. It decreases inflammation throughout the colon with a targeted delivery of medicine throughout the full length of the colon, where the disease is located.
Because of the way UCERIS is absorbed and processed in the body, most of it does not enter the bloodstream, and therefore it has a safety profile similar to placebo (sugar pill). UCERIS also helps heal the lining of the colon. UCERIS decreases the severity of inflammation in the colon, thereby helping to eliminate UC symptoms.
UCERIS is a single pill taken once a day by mouth for up to 8 weeks. Additional 8-week courses can be given for patients whose UC remains active. 


What happens after taking UCERIS? Unlike typical steroids, which act on the whole body, UCERIS targets the area where the disease is located. The medicine travels through the digestive system and stays intact until it reaches the colon. Once it dissolves, UCERIS forms a type of gel and slowly releases medicine to the full length of the colon.How UCERIS Works
Ok, so I just filled my prescription of Uceris and it's a pretty expensive drug for the time being (too new for a generic form to be available).  People with GI conditions and autoimmune disorders spend a lot of money on maintaining their health, from doctor co-pays to specialty food to the various medications one must take.  The monthly cost of this disease can be devastating.  I wanted to share the different savings offers that are available for qualified individuals.  


  • Here is the list -  Please note:  I have not checked SCBN.org or goodrx.com about the offers.  I just did the searching and posting for you.  Offers status at this time on specific drug is unknown, as i didn't read each sites qualifying info andterms of offer.

$25 Co-pay Program | UCERIS (budesonide) Extended Release Tablets: - Manufacturer offer*


http://medicinecoupons.net/Medicine-UCERIS-coupon

http://www.internetdrugcoupons.com/Uceris-Coupon *This site gives people with no drug coverage an option to save.  The manufacturer does not have an offer for cash paying individuals (I have no idea why. Makes no sense when these would be the people that would need the most help paying for medication).

http://www.goodrx.com/uceris

https://www.pparx.org/ The Partnership for Prescription Assistance helps qualifying patients without prescription drug coverage get the medicines they need through the program that is right for them. Many will get their medications free or nearly free.

http://www.needymeds.org/ NeedyMeds is a 501(c)(3) non-profit information resource devoted to helping people in need find assistance programs to help them afford their medications and costs related to health care. 

http://healthfinder.gov/FindServices/SearchContext.aspx?topic=696 US Dept of Health Resource Page

http://www.scbn.org/  





Wednesday, May 22, 2013

Higher Risk of Melanoma in IBD Patients

Gee great!! I'm just gonna die.. my God.  Melanoma was the cancer that killed my mother, making the % higher for me.  I didn't even read the article.  The title says enough.  Maybe one day i'll decide to scan my eyes over the words, but for now I don't feel like going there.  Click the link to go to the original article if you'd like to read it. 




'via Blog this'

Monday, May 6, 2013

Fecal Transplantation Helps Kids w/ Ulcerative Colitis #UC study shows

Sounds promising from everything i've read and continue to read.  
  • How do they get the fecal microbes into the person? According to the article, this is how it's done.  "To perform the transplant, a stool sample must be provided by a healthy adult, usually a family member or close friend. It is mixed with a saline solution and filtered to remove particles that could block the tube. It is given to the patient as an enema in a process that takes more than an hour." 
"Hey sheester, can you s*** in this cup please?"  How does one go about obtaining someones poop?  Hand them the bag with the sample cup and say "# 2 ..not 1."  If they look at you weird and they will, i'm certain.  Say "just do it, it's for a good cause"  



The ultimate probiotic: Unusual treatment helps kids with ulcerative colitis, study shows | MLive.com:

GRAND RAPIDS, MI – Life can be miserable for a kid who has ulcerative colitis.
Bouts of severe diarrhea, cramping and pain can cause them to miss school or avoid social activities. Medications to treat the condition can cause severe complications. The disease can delay growth. Some kids eventually have to undergo surgery to remove their colon.
That is why an alternative, drug-free treatment is raising hope – even as it raises eyebrows among those unfamiliar with it.
At  Helen DeVos Children’s Hospital, a pediatric gastroenterologist is getting good results for patients using fecal transplants. Stool from a healthy donor – often a parent - is given to the patient through an enema in an attempt to restore healthy bacteria in the child’s intestine.
“It’s the ultimate probiotic,” said Dr. Sachin Kunde.
Kunde conducted the first clinical trial in the country to study the use of fecal microbial transplantation on children with ulcerative colitis. Only 10 patients were involved in the trial, but the results were promising.
The symptoms cleared up in three of the children – and they stayed symptom-free for at least a month. Another six saw improvements, which also lasted at least a month. For example, the number of daily bowel movements may have dropped from 10 to five, Kunde said. One child was unable to retain the enema.
The results of the study were published online by the Journal of Pediatric Gastroenterology and Nutrition and will be featured in the June print edition.
The study has stirred excitement among parents of children and young adults with ulcerative colitis, a form of inflammatory bowel disease that affects the lining of the large intestine or rectum.
“We had at least 50 patients in one year calling to be enrolled in the study,” Kunde said. “They want it because they don’t want medication. They think this is a fix.”
But Kunde balanced hope with caution. A larger study is needed to test the treatment’s effectiveness, he said. He has applied for funding for further research and is looking into whether the experimental treatment can be offered outside of a research setting.
Kunde said he first thought of using fecal transplants to treat ulcerative colitis during his fellowship at Emory University in Atlanta. They have previously been used experimentally to treat C. difficile infections.
Within a month of joining DeVos Children’s Hospital in 2011, he proposed the clinical trial to the Spectrum Health institutional review board. He also had to obtain approval from the Food and Drug Administration, because human stool is considered a drug and a biologic.
To perform the transplant, a stool sample must be provided by a healthy adult, usually a family member or close friend. It is mixed with a saline solution and filtered to remove particles that could block the tube. It is given to the patient as an enema in a process that takes more than an hour.
“We believe that the procedure may restore ‘abnormal’ bacteria to ‘normal’ in patients with ulcerative colitis,” Kunde said.
The pilot study involved 10 children and young adults, ages 7 to 20. They received a treatment a day for five days, and then their symptoms were evaluated.
Hospital staff made sure the patients did not see or smell the fecal transplant, which decreased anxiety and uneasiness about it. Kunde said awareness about the treatment is needed so people will readily see it as an acceptable option.

However, many struggling with severe symptoms of ulcerative colitis – adults and children – don’t need convincing, Kunde said. The disruption of life can be a significant psychological burden on patients and their families.
“People want this to be gone,” he said. “I don’t know if it will be gone or not. But it is a new hope for them.
“If we can help at least 30 percent of the patients, that is important.”
Contact Sue Thoms: Email. Twitter. Facebook.
http://www.mlive.com/news/grand-rapids/index.ssf/2013/04/fecal_transplant_-_the_ultimat.html