A London doctor is on the cusp of the biggest breakthrough in a decade in the treatment of Crohn’s disease and colitis — conditions that afflict more than 200,000 Canadians

Brian Feagan of the Robarts Research Institute has successfully tested the medication Vedolizumab, which targets an over-active immune response in the gut while sparing the immune system elsewhere, an approach that has avoided the risks of conventional therapy.

After three stages of clinical trial, Feagan’s work has been so promising, the drug company Millennium Pharmaceuticals Inc. is expected to apply within months for regulatory approval in Canada and the United States.

Vedolizumab would be the biggest advance in the treatment of inflammatory bowel diseases since about a decade ago, when approval was given to drugs that suppress the entire immune system.

“It looks incredibly promising,” said Jamie Gregor, a London gastroenterologist.

Current medications have been effective for many people but carry the risk of systemic infection and other serious complications, such as tuberculosis — something Feagan thinks can be avoided with Vedolizumab.

“There’s much less risk,” he said. “It’s been very gratifying (research).”

Vedolizumab isn’t the only drug in the pipeline to take the targeted approach but it may be the first considered by regulators, he said.

It’s of special interest in Canada, where rates of inflammatory bowel disease are among the highest in the world.

Feagan is hopeful Vedolizumab will be on pharmacy shelves within a few years.

He presented his findings to the 2012 annual meeting of the American College of Gastroenterology.

Feagan hopes that strong safety records mean approval is given to use the drug as a first-line treatment and not just when conventional therapy fails.

There is no cure for inflammatory bowel disease because scientist don’t know precisely what causes it, but they suspect the body’s own immune system plays a significant role and attacks the lining of the digestive tract. Common symptoms include diarrhea, rectal bleeding, incontinence, abdominal pain, fever, fatigue and weight loss. When treatment fails, surgery may be needed.

jonathan.sher@sunmedia.ca

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THE TRIAL

In a trial of the medication Vedolizumab, there were benefits to many Crohn’s disease/colitis patients, including those who had not done well with conventional therapy.

After one year more than 40% were in remission compared to 15% in the placebo group. In more than half those who received the drug, their guts showed healing, compared to just 20% of those who received the placebo.

Adverse events in the treated group were no higher than in those who were given the placebo.