Promising new therapy for ulcerative colitis

For people with the chronic disease ulcerative colitis, life can be limited to few social functions and trips away from home.

A promising new therapy pioneered by University of Kentucky gastroenterology specialists may offer improved lives to patients suffering from moderate to severe forms of the disease.

Ulcerative colitis causes inflammation and ulcers in the colon, leading to abdominal pain and such frequent trips to the bathroom that normal routines can be disrupted. Finding the right treatment can be difficult, with therapies that may include steroids and anti-inflammatory drugs, or possibly surgery in as many as 25 to 40 percent of ulcerative colitis patients.

A drug already used for other inflammatory diseases, including Crohn's and rheumatoid arthritis, has received FDA approval for treatment of ulcerative colitis after performing well in clinical trials. UK was a primary investigator of infliximab, brand name Remicade, and enrolled the largest study group in North America.

"It's a very welcome addition to our treatment options," said Willem J.S. deVilliers, M.D., Ph.D., chief of the UK Division of Digestive Diseases and Nutrition. DeVilliers co-authored a report of the trial, which was recently published in the New England Journal of Medicine.

One of the study participants is Robert Lewandowski, of Hager Hill in Johnson County. Lewandowski was diagnosed with the disease a decade ago and saw the retirement plans he and his wife made slipping away as he became more and more reluctant to leave home.

"The first thing you do is when you think about going somewhere, you have to think about where the bathroom is and how quickly you can get to it," Lewandowski said. "Eventually, you stop going and doing things because it's too much of a problem."

Lewandowski's disease went into remission after a few years, then reappeared, sending him to the bathroom 20 or more times a day. Therapies he used in the past didn't work, so his physician referred him to the clinical study at UK. He saw an improvement almost immediately, and a year later, he is able to lead a normal life, with no symptoms of the disease. "I'm happy," he said.

The medication is administered intravenously, with an initial regimen of three doses of infliximab, followed by maintenance infusions every eight weeks. Nearly 70 percent of patients receiving the drug experienced clinical response and remission early in the trial, and nearly all had significant results after one year of therapy.