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Article on CNN about treatments

http://www.cnn.com/2012/08/14/health/doctors-crohns-treatment/index.html?iref=allsearch

Above is addressof CNN article About new treatments for Crohns....catchy headline...but never identified any new treatments! In addition it seems to be geared towards the people suffering from this....then describes Crohns as if it is talking to a lay person...I don't get it??
Publicity hungry doctor??
I believe the dr involved dr rubin is the dr known for suggesting fecal transplants....I sure appreciate that he suggests two very new treatments coming soon but I sure would have liked an idea of what they areand what they involve....
Anyone know what he speaks of?
 

nogutsnoglory

Moderator
I got a call from a friend saying I must read this. I was excited by the title but disappointed to learn nothing. Are these new meds immunosuppressants or biologics? If its in the same category I'm not interested nor impressed. We need a way to control crohns by regulating the immune system (like LDN possibly does) not to suppress it.
 
I keep hearing about LDN, I know that's low dose naltrexone, but I haven't researched what it does or where to get it.
 
This is a hilarious article "Step right up new medications!" What are they, can you name one? They are talking about biologics, back in the 90's they had a bottom up approach to Crohns where they just treated symptoms and worried more about patient toxicity. Now with Biologics they have a top down approach which includes hitting it hard quickly and slowing the advancement of the disease. Wait for the probiotic treatment to come in the next 10 years thats the one I'm looking for!
 

Kev

Senior Member
I can give you a brief (and for the most part accurate.... or at least as accurate as my memory AND technical understanding permit) run down on low dose Naltrexone (LDN).

Here goes... In late spring/early summer of 2007, a report was published in the American Journal of Gastro-enterology of a clinical trial of treating Crohns with 4.5mg of Naltrexone by Dr Jill Smith at Penn State University. It was a small, low budget study, but it showed that this method offered substantial success rates as well as few/if any side effects to worry about. I was running out of options... I'd just been hospitalized by a toxic reaction to AZA. Metho and Remi were the only drugs left to try in the 'standard' treatment package, and they came with a lot of caveats, and I couldn't possibly afford Remi... So, I downloaded the synopsis of the study, took it to my GI. She researched it, and to my great surprise and relief, she agreed to try me on it. That was November of 2007. Here I am, almost 5 full years later. My disease is in check, I got my life back, and all it requires is a 4.5 mg custom compounded pill of Naltrexone each nite @ bedtime.
My GI was soooo pleased at my results, she has since given another 4 or 5 patients LDN AND she prepared and presented a paper to the other GI's here about treating with LDN.

Considering its effectiveness AND relative safety, I'm amazed that it remains relatively obscure 5 years after the initial study/report. I mean, it is a shame... almost a sin.. that doctors don't even know/present the info about it to their patients for consideration.
 
Thank you Kev! We will be going for a gi visit within the next month. Would you mind somehow getting me a copy of the paper from your gi and/or the information you took to her initally? VERY much appreciated.
 
Thanks for posting this and yes it was disappointing that there wasn't much new information at all.
Dr Rubin is highly regarded and I contacted him by email when we were trying fecal transplants for my daughter with UC. He believes it is a potential treatment but is very cautious as they have not gone through clinical trials. It was my understanding that they were very early in the application process to start trials. Other docs in the US and abroad (of course Dr Borody in Australia) are doing FTs for UC already.
To be honest, I am losing hope for new treatments for this disease. Since my daughter's dx three years ago, I've researched extensively and tried so many things and keep hearing about multistem and other promising treatments but so far it seems like a pipe dream.
As for LDN, we've tried it long term twice but unfortunately it didn't work for us. A GI who is treating my friend's daughter with severe CD even contacted Penn State to find out where they were with their research (as he wanted to rx it for her but felt unsure without research backing it up) and it turns out that the second study hasn't been published yet because the results were not as promising as they had hoped.
Sorry to be a downer all but I am so frustrated by the same old same old and by this monster disease.

Sherry
(mommy of daughter dx age 3 with UC. hoping it stays that way and it's not CD).
 

DustyKat

Super Moderator
You aren't being a downer Sherry...:hug:...just honest and open and that is a good thing. We need to hear every side of a story/experience so we can all make informed decisions. Thank you. :)

Dusty. xxx
 
Unfortunately, I am of little value regarding LDN as I have no experience with it. I,like most people here, am a seeker of information. I m optimistic that LDN offers us a reliable back up plan the future. All of what i know came from Internet research and people's accounts here.
I do know that dr Jill smith s results had not been published yet; but I have not heard that this was due to poor results. Where did that information come from? Can anyone confirm this allegation?
We have had contact with her people and they still recommended providing our GI with the info and never mentioned poor results.
 
Thanks for your kind words Dusty. I just don't want to discourage others from trying alternative treatments as they do work for some but I feel we should have access to as much reliable information as possible. Clearly LDN has worked very well for some people.
Dutch, I trust that the information about the Penn State studies is correct. They have not been published because of poor results. My friend has a four year old with severe crohns which manifested post colectomy (her original dx was UC and it was very severe - surgery a year from dx). Her (pediatric) GI is very reluctant to use biologics due to her age. She was not given remicade before surgery. He is very conservative with medication. My friend and the GI do not want to resort to Imuran (she is on EN and though she is clinical remission on a NG tube her bloodwork indicates inflammation). He did a lot of research on LDN and contacted the docs at Penn State and this is what he was told.
In my personal experience it did not work. Neither did all sorts of diets (scd, paleo, sugar/fruit/honey/grain/dairy free etc etc), meds, fecal transplant, chinese medicine etc etc. That does not mean they don't work for anyone at all. It's just good to know what the likelihood of success is for a particular treatment and I would like to know rom Penn state. You could email Jill Smith (or ask your GI to do so) and see what they are finding so far. I've emailed them in the past and her assistant has always written me back. You can also try emailing Dr Zagon there, one of the researches who discovered LDN's potential use in AI disorders. I've been in touch with him as well.
FYI, our GI clinic and the GIs at U of Chicago refuse to use LDN based on failure to show results. Having said that, I believe some GIs use it. It's a shot in the dark like everything else with this disease. I hope your son does well on it.
 
Oops, Dutch, Just reread your post and I see you're in touch with Jill Smith's people. They told us the same thing. Our GI refused to rx it and we found another way to get it. They presented their study at the Digestive Diseases conference a few years ago and our GI felt it was not encouraging. End of story.
It might be worth your GI contacting them directly and asking about the results/reasons for not publishing until now. In my experience, it's more likely that they will divulge this to a colleague as opposed to a parent or patient. I also believe they've applied for some sort of patent for LDN in this treatment but of course that doesn't mean too much though it is worth noting IMO.
 
I am not certain if the Dr. David Rubin associated with the pretty useless article is the one who does the fecal tranplants.

Dr. Timothy Rubin at Essentia in Duluth MN is one of the doctors doing the work with fecal transplants, but only for the treatment of C-Diff infections. He does not do any for Crohn's or other bowel diseases. I asked.

There seems to be a glut of "Dr. Rubins" and it is hard to know one from the other.

I agree with Kev. We have a very safe and often effective treatment with LDN, but because a Pharma salesman is not pushing it, not many doctors are even aware of it, much less prescribe it.

Dan
 

David

Co-Founder
Location
Naples, Florida
As for LDN, we've tried it long term twice but unfortunately it didn't work for us. A GI who is treating my friend's daughter with severe CD even contacted Penn State to find out where they were with their research (as he wanted to rx it for her but felt unsure without research backing it up) and it turns out that the second study hasn't been published yet because the results were not as promising as they had hoped.
Papers aren't not published because of poor results. Research doesn't work that way. Publishing poor results can be just as important as good results. I don't believe that "poor results" is the reason for a second.

I'd be very careful about making such claims as they're very likely incorrect.

FYI, our GI clinic and the GIs at U of Chicago refuse to use LDN based on failure to show results.
So they don't use any form of mesalamine such as Pentasa or Apriso for Crohn's disease either then?
 
Here we go.
Dan - yes it is David Rubin at University of Chicago. He does not, as I mentioned earlier, do fecal transplants but since he is one of the most prominent GIs in the country his acceptance of this treatment is a sort of a breakthrough. Having said that, at the time I exchanged emails with him last year he was cautious about its success without having carried out trials regarding its safely and efficacy . As I mentioned, they (U of C) are in the process of applying to the FDA to begin trials. I don't know where they are in this process. Of course, and very happily, there are other and an increasing number of GIs who are finally facilitating FTs for UC (as opposed to "just" for C diff - and by that, before I create an uproar, I know C Diff is horrible and life threatening etc but until very recently it was the ONLY way to have get a GI to do FT).
David, I know that research is led by "big pharma" unfortunately but the fact remains that the first LDN study was published. The second was not. When my friend's daughter's GI wanted to rx it for her, he dug deeper and this is what he was told. I am passing this information on. I believe I am entitled to pass this on and honestly considering the monumental claims made for LDN (cure for everything from MS to cancer to RA and as you know the list goes on) I think it's good, especially as parents absolutely desperate to do anything and everything to cure our children, to have some actual information on this. As I said, it DOES work some but we don't know the stats. And I have tried it twice. And if I were in the position again, I would probably consider trying it again but then I would love there to be more information about this drug.
As for whether our GIs use ASAs to treat CD, to be honest I don't know if they do as my daughter's current dx is UC. And, I know several people who are in full remission from their CD on pentasa. Why is it that it's okay for someone to be in remission on LDN but not an ASA? I know there are studies which show that ASAs are not effective in the treatment of CD but I'm not up on them. I do know that a pubmed search will generate all sorts of papers showing the efficacy of all sorts of herbs, diets, meds etc for IBD and often papers contradicting them as well.
Lastly, as I've posted before, our GI DID actually support our desire to try FTs for my daughter. She feels it's a very promising therapy and has another patient for whom it worked well. She does not feel the same about LDN and has patients who have tried it but not for whom it works. So that was her position. I can't really criticize or defend her on this but that is what it is.
I know we are all looking for a cure or at least a drug which puts this monster into remission without side effects and for some LDN is that drug. But I was posting my experience of it and that of my friend's. I don't think I need to be cautioned against doing so and find it a little odd that you feel the need to do that. You and anyone else is welcome to ignore what I've posted here but the fact on this and try to verify the LDN trial results yourselves.
I'll stop now as it's very late and I'm getting grumpier as I write this.
I hope everyone here finds a very long remission for their kids.
 

David

Co-Founder
Location
Naples, Florida
David, I know that research is led by "big pharma" unfortunately but the fact remains that the first LDN study was published. The second was not. When my friend's daughter's GI wanted to rx it for her, he dug deeper and this is what he was told. I am passing this information on. I believe I am entitled to pass this on and honestly considering the monumental claims made for LDN (cure for everything from MS to cancer to RA and as you know the list goes on) I think it's good, especially as parents absolutely desperate to do anything and everything to cure our children, to have some actual information on this. As I said, it DOES work some but we don't know the stats. And I have tried it twice. And if I were in the position again, I would probably consider trying it again but then I would love there to be more information about this drug.
"My friend's daughter's GI was told..."

Have you ever played the game, "Telephone"? Where each step the original message gets relayed it gets screwed up more and more? What I'm saying is the message you're relaying is not logical. And if you are indeed incorrect then you are doing a tremendous disservice to people so I hope you're really certain about the validity of your information. Believe me, I want more data too. In the meantime, we need to be very careful that what we do put forth is as good of information as possible. Do you really not see the potential disservice of making claims about studies that haven't been published via information that has had multiple relays?

As for whether our GIs use ASAs to treat CD, to be honest I don't know if they do as my daughter's current dx is UC. And, I know several people who are in full remission from their CD on pentasa. Why is it that it's okay for someone to be in remission on LDN but not an ASA? I know there are studies which show that ASAs are not effective in the treatment of CD but I'm not up on them.
My point is I'd bet good money that your GIs use mesalamine for Crohn's disease when the studies don't show strong statistical evidence that is is useful for Crohn's disease and plenty of studies including a Cochrane review that tear it apart. Now, obviously they can't try everything under the sun and I respect that, but if a parent or patient comes to them and says, "We want to try LDN" and they refuse based upon the data yet routinely prescribe mesalamine, well...

As for your whole, "Check for yourself" argument. If you're going to put forth something as fact, you're the one who should be verifying your facts first. If it was first hand experience, it would be welcome. If it was a verified fact it would be so very welcome whether positive or negative as I simply want the best information possible for members and guests here. But you're spreading rumors and we shouldn't have to spend our time verifying rumors.

I realize you're only trying to help and I greatly appreciate that. We just have to be very selective about what information we present. Over 175,000 unique visitors came to this site in the last 30 days. Every single post here makes a difference and we need to make sure that difference is as positive as possible. Information spreads around the net in an instance, let's make sure the information we present is as factual as possible.

Thanks :)
 

David

Co-Founder
Location
Naples, Florida
Papers aren't not published because of poor results. Research doesn't work that way. Publishing poor results can be just as important as good results. I don't believe that "poor results" is the reason for a second.

I'd be very careful about making such claims as they're very likely incorrect
Low Dose Naltrexone For Crohn's Disease Study One
Low Dose Naltrexone For Crohn's Disease Study Two

Excellent results from both studies. Study two had 40 participants with moderate to severe Crohn's disease. Not only did 88% have a reduction in symptoms but 78% had mucosal healing evident by colonoscopy.
 
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