Cimzia

Crohn's disease is a chronic inflammatory bowel disease that affects one million men and women worldwide. The disease results in inflammation of any area of the gastrointestinal tract. But, it commonly affects the ileum which is the lowest part of the small intestine. The symptoms are similar to other intestinal problems making the diagnosis difficult. Some of the symptoms are fever, diarrhea, rectal bleeding, malnutrition, cramping, obstructions, abscesses and abdominal pain. Crohn's disease appears to also have a familial association with about 20% of people having a relative with a history of inflammatory bowel disease.

On April 22, the FDA approved Cimzia (certolizumab pegol) for use in people who do not respond to other forms of therapy for Crohn's disease. The drug company UCB developed Cimzia for adults with moderate to severe Crohn's disease. The drug works by blocking the tumor necrosis factor (TNF) alpha. TNF-alpha is a protein that is part of our immune system. In the event of infection, the body triggers an immune response in which TNF-alpha is called into the picture. The protein works by mobilizing white blood cells to help fight the infection which leads to inflammation at the site. Under normal circumstances, TNF-alpha would be removed after the infection is cleared up. However, for those suffering from inflammatory diseases such as rheumatoid arthritis or Crohn's disease tumor necrosis factor alpha is not removed. The presence of TNF-alpha after an infection causes more white blood cells to be signaled to the area. This results in excessive inflammation which causes tissue damage and pain.

Cimzia is an injection that is given to patients every two weeks for the first three injections to establish that it works. Dr. Julie Beitz, M.D., director at the FDA's Center for Drug Evaluation and Research stated, "This drug works to reduce the signs and symptoms of Crohn's, but it also carries risks that will require patients on it to be closely monitored by their physicians or other health care professionals." While some of the commonest side effects are headache, upper respiratory infections, abdominal pain, injection site reactions and nausea patients can experience some more severe reactions.

Since Cimzia works by inhibiting TNF-alpha it lowers the body's ability to fight infections making people more vulnerable to diseases like tuberculosis. Although the Cimzia study did not show an increase risk for cancer blocking TNF-alpha may cause lymphomas or malignancy. Other TNF-alpha blockers have been shown to result in certain cancers. For those who are unable to get help from conventional therapies (e.g. antibiotics, anti-inflammatory drugs or steroid) Cimzia offers Crohn's disease patients relief from their symptoms.

Sources: http://www.webmd.com/ibd-crohns-disease/crohns-disease/news/20080423/fda-oks-new-crohns-disease-drug-cimzia, http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/