Twice-daily pill to beat bowel dis­ease

The Scottish Mail on Sunday - - Health - By Pat Ha­gan

A ‘LIFE-TRANS­FORM­ING’ drug for se­vere bowel dis­ease has won NHS back­ing af­ter stud­ies showed that pa­tients given the twice-daily pill can go into com­plete re­mis­sion af­ter years of suf­fer­ing.

Some of those who took part in tri­als got bet­ter even though they had failed to re­spond to all other treat­ments.

The £8,000-a-year med­i­ca­tion has now won the sup­port of the spend­ing watch­dog, the Na­tional In­sti­tute for Health and Care Ex­cel­lence (NICE), which has ap­proved the treat­ment for pa­tients south of the Border with mod­er­ate to se­vere ul­cer­a­tive col­i­tis. The drug, to­fac­i­tinib, is ex­pected to be avail­able on the NHS in Eng­land and Wales from early next year. A de­ci­sion in Scot­land is due in Fe­bru­ary.

Ul­cer­a­tive col­i­tis, caused by the im­mune sys­tem go­ing hay­wire and at­tack­ing healthy bowel tis­sues, af­fects 146,000 Bri­tons.

Many are young as the ill­ness tends to strike be­tween the ages of 15 and 25 and causes de­bil­i­tat­ing symp­toms, rang­ing from re­cur­rent di­ar­rhoea to un­planned weight loss.

Con­sul­tant gas­troen­terol­o­gist Dr Bar­ney Hawthorne, of Uni­ver­sity Hos­pi­tal Wales in Cardiff, wel­comed the de­vel­op­ment. ‘Ul­cer­a­tive col­i­tis is a rot­ten dis­ease and one in ten pa­tients ends up hav­ing the colon re­moved,’ he said.

‘Other strong drugs we use are given by in­jec­tion of in­tra­venous drip, and pa­tients can be­come re­sis­tant to them, so they no longer work. There is less chance of this hap­pen­ing with the new med­i­ca­tion, and as it’s a tablet, pa­tients can take it at home, which is far more con­ve­nient.’

Cur­rent drug treat­ments for ul­cer­a­tive col­i­tis in­clude steroids that dampen down in­flam­ma­tion and oth­ers that try to turn down the im­mune sys­tem’s re­sponse.

These can be very ef­fec­tive, but some suf­fer­ers still end up need­ing surgery to have part of the dam­aged colon re­moved.

The new to­fac­i­tinib pills, taken twice daily for eight weeks, then at a lower ‘main­te­nance’ dosage, could of­fer these pa­tients hope.

Shirley Leather, 46, from Sus­sex, has seen her qual­ity of life change be­yond recog­ni­tion since be­ing put on to­fac­i­tinib in a trial in 2014.

The mother-of-two, a ware­house man­ager, had suf­fered with ul­cer­a­tive col­i­tis for a decade. The condi- tion struck in 2004, shortly af­ter the birth of her first child. She blamed the di­ar­rhoea and pass­ing of blood on ‘part of the process of preg­nancy’. But at her six-week check-up her GP re­alised some­thing was wrong and re­ferred her to a spe­cial­ist. Shirley was told she had ul­cer­a­tive col­i­tis.

Oral steroids helped at first, but her weight bal­looned and her self-es­teem plum­meted.

‘At my worst I would go to the toi­let 27 times a day,’ she says. ‘The fa­tigue was over­whelm­ing. Most days I would have to sleep in the af­ter­noon, try­ing to make my two young chil­dren un­der­stand that Mummy needed to sleep and that they must play qui­etly.

‘By the time I was of­fered this trial, I was at my very low­est and des­per­ate to find any­thing that could give me back some sort of qual­ity of life.’

To­fac­i­tinib is a type of drug called a Janus ki­nase in­hibitor, or Jakinib. Janus ki­nases are en­zymes that help to ac­ti­vate the im­mune re­sponse. By block­ing the ef­fect of the en­zymes, the drug stops the im­mune sys­tem de­stroy­ing healthy tis­sue.

It can have side-ef­fects – in­clud­ing chest in­fec­tions, headaches and di­ar­rhoea – but Sarah Berry, from Crohn’s and Col­i­tis UK, a char­ity which pressed NICE to back the drug, said: ‘This drug of­fers a huge amount of hope.’

Shirley says: ‘Life has been a roller­coaster with ul­cer­a­tive col­i­tis. But I can hon­estly say this drug has to­tally changed my life. I have been in re­mis­sion for over three years and feel like a com­pletely new per­son.’

Newspapers in English

Newspapers from UK

© PressReader. All rights reserved.