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  • Jefferson Adams
    Jefferson Adams

    Are Celiac Disease Drug Treatments Just a Pipe Dream?

    Reviewed and edited by a celiac disease expert.

    We're running low on viable drug candidates for treating celiac disease outside of a gluten-free diet.

    Are Celiac Disease Drug Treatments Just a Pipe Dream? - Art For art's sake. Image: CC BY-SA 2.0--Thomas Berg
    Caption: Art For art's sake. Image: CC BY-SA 2.0--Thomas Berg

    Celiac.com 09/21/2022 - The dream of creating a safe, effective drug that can help people with celiac disease to tolerate small amounts, or perhaps even large amounts, of gluten. Until its recent failure, 9 Meters' larazotide was the only celiac drug in Phase 3 clinical trials. The recent discontinuation of larazotide, based on disappointing interim results, highlights the unmet need for effective alternatives to a gluten-free diet for treating celiac disease. 

    Larazotide's failure also opens the doors for current and future Phase 1 and Phase 2 celiac therapies to be first-to-market. It also highlights the lack of a good lineup of potential new drugs. The reality is that, with the collapse of several once promising candidates, the bench for viable alternative celiac disease treatments is shallow, at best.

    Current Celiac Disease Pipeline Therapies Include:

    • Latiglutenase (ImmunogenX)
    • PRV-015 (Provention Bio, Inc. with Amgen)
    • TAK-101 (Takeda Pharmaceuticals)
    • ZED-1227 (ZEDIRA GmbH)
    • KAN-101 (Anokion SA)

    Celiac.com Sponsor (A12):
    In an effort to assess the current and future alternatives for treating celiac disease without a gluten-free diet, data marketing company Spherix recently interviewed one-hundred US gastroenterologists, and conducted eight qualitative interviews to compile a report on the issue.

    Spherix has issued a recent report on the form gastroenterologists engaged in a thorough review of these pipeline product descriptions (based on publicly available clinical information for each product). The report assesses celiac diagnostic and treatment trends emerging, as well as physician reactions to potential therapies in the pipeline.

    The 2022 report reveals a greater sense of urgency from gastroenterologists versus the 2021 report. Indeed, the number of respondents in the 2022 survey who say that their celiac patient load has increased in the past year, is up by 60% over 2021.

    Read more at PRNewswire.com
     

     



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    Guest Keith

    I've all but given up on hoping I can eat normal food again.  Sad but there is little left to hope for. I have type 2 diabetes as well and a drug that can address Celiac Disease most likely would be useful for other autoimmune diseases.  Call me a cynic but give the state of Big Pharma these days, anything that has the potential to kill the golden goose by curing diabetes is doomed from the start.  30% of the worlds  population is expected to have diabetes of one type or the other and frankly that's a lot of money out there in worthless therapies.  Where there is that kind of revenue is a huge amount of greed and corruption.

    Not many diseases have been cured in the past 30 years and for good reason - Money.

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    trents

    I think this excerpt from the article is very important: "The 2022 report reveals a greater sense of urgency from gastroenterologists versus the 2021 report. Indeed, the number of respondents in the 2022 survey who say that their celiac patient load has increased in the past year, is up by 60% over 2021."

    60% increase in celiac patient load in one year! That could bring action on several fronts.

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    sc'Que?
    21 hours ago, Guest Keith said:

    Not Guest Keith, but rather trents said: 

    "I think this excerpt from the article is very important: "The 2022 report reveals a greater sense of urgency from gastroenterologists versus the 2021 report. Indeed, the number of respondents in the 2022 survey who say that their celiac patient load has increased in the past year, is up by 60% over 2021."

    60% increase in celiac patient load in one year! That could bring action on several fronts.

    We all sure-as-sheize hope so!  But, like Keith, I'm not holding my breath!

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    Dina Wright

    I was diagnosed with Celiac disease 15 years ago. I struggled initially with eating gluten free but have now become a “pro” at making sure I don’t get glutenized when eating out, (I’ve walked out of many restaurants without certainty of avoiding “cross contamination”). 

    So much attention to celiac disease has helped when it comes to eating gluten free, I’m thankful for that! 

    In the last year I was told, by a friend who isn’t celiac, just avoids gluten for other reasons. This friend told me that she and her husband were able to drink Corona Premier without any issues. I tried it, reluctantly, and found that I was able to drink as many as I wanted without issue!! For me, having a “real” beer was exciting! This may not be the case for all celiacs but for this afflicted celiac, it’s been a life changer!

     

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    trents
    8 minutes ago, Dina Wright said:

    I was diagnosed with Celiac disease 15 years ago. I struggled initially with eating gluten free but have now become a “pro” at making sure I don’t get glutenized when eating out, (I’ve walked out of many restaurants without certainty of avoiding “cross contamination”). 

    So much attention to celiac disease has helped when it comes to eating gluten free, I’m thankful for that! 

    In the last year I was told, by a friend who isn’t celiac, just avoids gluten for other reasons. This friend told me that she and her husband were able to drink Corona Premier without any issues. I tried it, reluctantly, and found that I was able to drink as many as I wanted without issue!! For me, having a “real” beer was exciting! This may not be the case for all celiacs but for this afflicted celiac, it’s been a life changer!

     

    "Ingredients: Water, Barley Malt, Non-malted Cereals, Hops" Open Original Shared Link

    Dina, barley malt contains gluten. This beer product is not gluten free. I would caution you to assume that just because you don't detect a gluten reaction means there is no inflammation of the small bowel lining happening. It may be just a low level inflammation but inflammation none the less. People who are avoiding gluten "for other reasons" seldom have to worry about minor amounts of it in what they consume.

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    Dina Wright
    2 hours ago, trents said:

    "Ingredients: Water, Barley Malt, Non-malted Cereals, Hops" Open Original Shared Link

    Dina, barley malt contains gluten. This beer product is not gluten free. I would caution you to assume that just because you don't detect a gluten reaction means there is no inflammation of the small bowel lining happening. It may be just a low level inflammation but inflammation none the less. People who are avoiding gluten "for other reasons" seldom have to worry about minor amounts of it in what they consume.

    This beer states that it is gluten free. I feel that the process of removing ingredients to make it a low fat/calorie beer is why. So many other beers that state to be “gluten removed” just doesn’t taste as good as this one. 

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    trents
    7 minutes ago, Dina Wright said:

    This beer states that it is gluten free. I feel that the process of removing ingredients to make it a low fat/calorie beer is why. So many other beers that state to be “gluten removed” just doesn’t taste as good as this one. 

    From Corona's website: "Corona Extra, Corona Light, Corona Familiar, and Corona Premier are made from malted barley which naturally contains gluten. The fermentation process significatively lowers its content, however, there are traces of gluten in Corona Extra, Corona Light, Corona Familiar, and Corona Premier." Open Original Shared Link

    So, you are saying that this product officially meets the less than 20ppm requirement needed to use the "gluten free" label claim? Does it say "gluten free" on the carton or the bottles?

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    Scott Adams

    It is true that some barley based beers are extremely low in gluten, but not 100% gluten-free. Some may be below 20ppm which means they would technically be gluten-free in many countries. This article may be helpful:

     

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    Guest Tine

    I recently wrote this article for Dutch celiac disease patients (translated with Google): 

     

    Research into medicines for celiac disease

    A drug to treat celiac disease? Some are looking forward to it. For others it is not necessary, they can manage just fine with a gluten-free diet. For the group that has difficulty with the gluten-free diet, because it has such a major impact on daily life, because complaints remain, or the intestines do not recover properly, a medicine is being sought in various countries. This can be a new drug, or a drug that is already being used for another disease. These are the main drugs currently being tested:
    1. enzymes that should make gluten less harmful (AN-PEP, Latiglutenase, TAK-062)
    2. Injections with substances that reprogram the immune system to accept gluten (TAK-101)
    3. a German drug that disables the enzyme tissue transglutaminase (TTG), so that the small intestine is no longer damaged after eating gluten (ZED1227)
    4. a drug to reduce inflammation (PRV-015); the Amsterdam UMC is one of the many hospitals in the world where this drug is tested in celiac patients
    5. the drug teriflunomide, originally intended for the treatment of MS, is being tested in Norway by a small group of celiac patients; they are allowed to eat gluten for three days and receive either the drug or a placebo (fake drug). It is being investigated whether celiac patients who receive the MS drug become less ill.

    These drugs are dots on the horizon for patients with celiac disease. They beckon, but at the same time they are still far away. The development of a drug, for any disease, takes years. And many initiatives that at first seemed promising, fail along the way, because they are not as good as hoped (Nexvax2 and Larazotide are examples of this). The gluten-free diet sets the bar high: a new treatment must be at least as good, and preferably even better. Now we just have to wait and see what the future brings, whether there is a drug in between that makes it to the finish line.


    Source:
    Dieckman T, Koning F, Bouma G. Celiac disease: New therapies on the horizon. Curr Opin Pharmacol. 2022 Jul 31; 66:102268. doi: 10.116/j.coph.2022.102268.

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    trents

    I'm thinking along the lines of some kind of gene therapy. Now that we have the genome gun it seems like a possibility.

    Another line of research I haven't heard anything on in a few years is modification of the gluten gene in the wheat/barley/rye itself to produce varieties with the baking qualities desired but which are harmless to celiacs.

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    Jcar
    On 9/27/2022 at 10:39 AM, trents said:

    "Ingredients: Water, Barley Malt, Non-malted Cereals, Hops" Open Original Shared Link

    Dina, barley malt contains gluten. This beer product is not gluten free. I would caution you to assume that just because you don't detect a gluten reaction means there is no inflammation of the small bowel lining happening. It may be just a low level inflammation but inflammation none the less. People who are avoiding gluten "for other reasons" seldom have to worry about minor amounts of it in what they consume.

    I agree with the cautionary comments. I was at a local brewery, Cabarrus Brewery in Concord, NC. They say they produce a gluten free beer brewed with barley that is treated with an enzyme then filtered that makes gluten well below 20 ppm which I believe is the standard. I did not taste but am curious. Anyone knowing of this beer or the process please comment. Thanks 

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    trents
    26 minutes ago, Jcar said:

    I agree with the cautionary comments. I was at a local brewery, Cabarrus Brewery in Concord, NC. They say they produce a gluten free beer brewed with barley that is treated with an enzyme then filtered that makes gluten well below 20 ppm which I believe is the standard. I did not taste but am curious. Anyone knowing of this beer or the process please comment. Thanks 

    Judging from what we see on this forum from user input abou these kinds of altered wheat/barley products, whether it be beer or pizza, where the gluten has supposedly been almost all removed, is that they work for the majority of celiacs but not for hypersensitive element of our community. We get a lot of comments to the effect that people are still being made ill by consuming these products.

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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


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