I should have posted about
the seminar when I got the first email about
it a few weeks ago. I forgot about
it until I got a reminder email yeseterday morning. I'll try to remember to post about
the next one well before the date.
The presentation lasted almost 2 hours, but most of it was information that most of us already know - symptoms, diagnosis and treatment. The treatment section was the most interesting since he talked about some newer treatments:
Remicade (not so new anymore): anti TNF - he said lymphoma risk isn't that high - 1-4 in 10,000, which he said is low considering the risk with a CT scan is 1 in 700. I'd like to know if that 1 in 700 is correct - seems quite high. Also talked about remicade and pregnancy. Babies seem to be born healthy to mothers that have been on remicade during their pregnancy, but they don't know how it affects the child's immune system later in life. He recommends women continue the remicade during the first 2 trimesters and stop during the last trimester because that is when the babies immune system is being developed. Then remicade can be continued after delivery because it does not cross into breast milk.
Humira: anti TNF - has about the same success rate as remicade.
Cimzia: anti TNF - not yet approved in Canada or Europe. Not approved in Europe because there was not enough data on it yet. They didn't try to get approval in Canada either until they have more data.
Abatacept: works by preventing full activation of T cells.
Adacolumn: an apheresis column developed in Japan. It absorbs granulocytes, monocytes and macrophages and returns the rest of your blood to you. I don't think it's approved here yet, but there are clinical trials.
Natalizumab (Tysabri) and Vedolizumab: both are humanized monoclonal antibodies against anti-adhesion molecules. They reduce the ability of inflammatory immune cells to adhere to cell layers in the intestine. Natalizumab was approved in the US in 2004 for MS and crohn's, but was removed from the market because it was associated with a neurological condition. It has since been reintroduced. Vedolizumab is in phase III trials for Crohn's and UC.
Stem cell transplant: one of his patients recently had a stem cell transplant, but I don't remember if it was for crohn's or UC and he has another patient who will soon be having a transplant.