Patients diagnosed with a debilitating bowel disease will soon be offered a game-changing drug that slashes the need for invasive surgery.
About half-a-million Britons suffer with Crohn’s disease, which causes agonising pain, diarrhoea, exhaustion and extreme weight loss. Around a third of patients living with the condition, where the gut lining becomes inflamed, will require surgery.
Many patients take several months to recover from the invasive procedure, while others are left with a stoma – where the bowel is diverted out of the body and replaced with a bag.
In recent years, some Crohn’s patients have been offered a drug called infliximab, which has been shown to reduce painful symptoms and limit severe complications.
Kelsea Lindsey, 33, (pictured) from South London, has undergone more than 20 operations since she was first diagnosed in 2010
Prof Miles Parkes (pictured), director of the National Institute for Health and Care Research Cambridge Biomedical Research Centre and co-author of the new study
However, due to its prohibitive cost, infliximab has been reserved for severely unwell patients.
But new research published last month has revealed that giving Crohn’s patients infliximab immediately after they are diagnosed leads to a ten-fold reduction in the number of surgeries required.
Now, the NHS is set to roll out the new treatment programme to Crohn’s patients, potentially saving thousands from surgery.
‘Giving infliximab early on led to amazing results,’ says Prof Miles Parkes, director of the National Institute for Health and Care Research Cambridge Biomedical Research Centre and co-author of the new study. ‘This will become the NHS standard of care for newly diagnosed Crohn’s patients.’
Crohn’s disease is an incurable condition in which parts of the digestive system become inflamed. Doctors aren’t sure what triggers it, but it is thought to be linked to an overactive immune system – fighter cells that are supposed to attack harmful toxins mistakenly destroy healthy tissue in the gut.
The damage can be extensive, affecting the entire digestive tract from the mouth to the back passage. Most patients, when first diagnosed, will be offered steroid medicines. However, these fail to stop flare-ups of the disease.
Many Crohn’s patients will still suffer extremely painful complications including abscesses – a collection of pus caused by a bacterial infection in the lining of the abdomen. The disease can also cause the bowels to narrow, making it difficult for food to pass through.
About half-a-million Britons suffer with Crohn’s disease, which causes agonising pain, diarrhoea, exhaustion and extreme weight loss (Stock image)
But in recent years, a new family of drugs called biologics have transformed Crohn’s treatment. These work by targeting specific proteins released by the immune system that cause inflammation.
Infliximab is one of these drugs. However, when it was first rolled out its cost – around £15,000 per patient, per year – meant it was rationed by the NHS. The new trial, of 386 people, gave half the participants infliximab as soon as possible after diagnosis. The other half were placed on the conventional treatment pathway, involving steroids. Roughly 80 per cent of patients on infliximab had their symptoms controlled for one year.
Crucially, ten patients given steroids required surgery due to Crohn’s, while no infliximab patients needed invasive surgery due to the disease.
Experts say this means that – due to the large expense of Crohn’s surgery – giving patients infliximab early on in their diagnosis could save the NHS money. The drug now costs £3,000 per year.
One patient who knows too well the danger of uncontrolled Crohn’s disease is Kelsea Lindsey, 33, from South London, who has undergone more than 20 operations since she was first diagnosed in 2010.
‘It was completely debilitating,’ says Kelsea, an executive assistant and ambassador for Crohn’s & Colitis UK. ‘I had to walk with a stick and was registered disabled.’
In 2014, Kelsea was fitted with a temporary stoma, which helped reduce the inflammation in her bowels. Today, her symptoms are under control, and she no longer requires a stoma. She says: ‘If my condition had been spotted sooner, and I started treatment, maybe all this could have been avoided.’