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    Jefferson Adams

    IMU-856 Shows Promise as a Potential Treatment for Celiac Disease

    Reviewed and edited by a celiac disease expert.

    Positive phase 1b trial results offer clinical proof-of-concept for innovative gastrointestinal therapy drug IMU-856.

    IMU-856 Shows Promise as a Potential Treatment for Celiac Disease - Image: CC BY-SA 2.0--ForestWander.com
    Caption: Image: CC BY-SA 2.0--ForestWander.com

    Celiac.com 05/15/2023 - Biotechnology company Immunic, Inc., focuses on developing oral, small molecule therapies for chronic inflammatory and autoimmune diseases, including celiac disease.

    Celiac disease is an autoimmune disorder that affects approximately 1% of people globally. People with celiac disease have an abnormal immune response to gluten, a protein found in wheat, barley, and rye. This abnormal immune response damages the lining of the small intestine, leading to malabsorption and other serious complications.

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    The company recently announced positive results from the Part C portion of its Phase 1 clinical trial of IMU-856 in treating patients with celiac disease.

    The trial consisted of 36 patients with celiac disease who were randomized to receive placebo or one of two doses of IMU-856 (80 mg or 160 mg) for four weeks, followed by two weeks of gluten challenge. 

    The trial assessed the protection of gut architecture, reduction of gluten-induced intestinal damage, improvement of patients' symptoms related to gluten exposure, dose-dependent changes in biomarker responses, and enhancement of nutrient absorption.

    The trial results showed that patients treated with IMU-856 had a dose-dependent reduction in gluten-induced damage to their intestinal villi, the small, finger-like projections in the small intestine that play a key role in nutrient absorption. The results also showed that IMU-856 restored the absorption of essential nutrients, such as vitamin B12, for red blood cell formation and the functioning of the brain and nervous system. 

    Immunic believes the clinical evidence supports IMU-856's ability to re-establish proper gut cell renewal, which could prove useful in treating other gastrointestinal diseases. Patients treated with IMU-856 also saw improvement in disease-related symptoms such as bloating and tiredness, and the treatment was observed to be safe and well-tolerated.

    IMU-856's ability to re-establish proper gut cell renewal, observed in preclinical studies, translates into clinical benefits for patients with celiac disease.  Most importantly, the observed protection of intestinal villi from gluten-induced damage, independent of celiac-specific targeting immune mechanisms, seems to be unique among proposed therapeutic approaches, and may be applicable to other gastrointestinal diseases.

    Immunic is now preparing for clinical phase 2b testing of IMU-856 in ongoing active celiac disease, while also considering other potential clinical applications for this first-in-class and orally available molecule.

    The positive results from the Phase 1 clinical trial of IMU-856 offer some hope for the development of a new therapeutic approach to treating celiac disease and other gastrointestinal disorders. The trial's success represents a significant milestone in the effort to develop safe and effective treatments for patients with celiac disease, and other chronic inflammatory and autoimmune conditions.

    The company believes that this data set provides initial clinical proof-of-concept for a new therapeutic approach to gastrointestinal disorders by promoting the regeneration of bowel architecture.

    Now, the story of a promising new celiac drug treatment is a story familiar to many of us. So far, the story has always ended the same way: the promising drug fails in the end. Here's hoping this one ends more happily.

    Stay tuned for more on this and related stories.


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    DocJeans

    This is a very small study of very short duration... and it has not been replicated.  It is extremely premature to conclude that this drug is effective or safe.

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    Russ H

    Even if it reduces symptoms, it does not treat the underlying pathological immune response.

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    M Susan

    And whatever medication is finally developed and approved will probably be very expensive.  

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    dixonpete

    My hookworms are still working for me.

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    Russ H
    14 hours ago, M Susan said:

    And whatever medication is finally developed and approved will probably be very expensive.  

    It certainly will be in the US!

    The only thing I have seen that might work is retuximab. It eliminates B cells (which generate antibodies) from the body, allowing a fresh set to be generated from stem cells. There are several case reports of people having therapy for other conditions achieving improvement in their refractory coeliac disease from retuximab. However, it is not safe enough for routine treatment of coeliac disease but it does show that the possibility of immunotherapy exists.

    https://academic.oup.com/rheumatology/article/53/10/1906/1816469

     

    1 hour ago, dixonpete said:

    My hookworms are still working for me.

    Do you have coeliac disease? The trial I saw showed no improvement.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678792/

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    sunny2012

    "reduction in gluten-induced damage to their intestinal villi"

    REDUCTION in damage. Those who got the drug and participated in the gluten challenge had LESS damage than those who got the placebo.  

    How much less?
    How much damage are those of us who have celiac supposed to accept as normal?
    What makes anyone think that damage to this critical part of the body is ever acceptable?

    How much of the small bowel was tested?
    How can we be certain that serious damage did not happen beyond the part of the small bowel that can be tested?

    What was the criteria for this measurement?

    Celiac nearly killed me before I was diagnosed. Please give me one reason why I would trust "LESS DAMAGE" as an acceptable measure compared to sticking with a 100% gluten free diet?

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    Caroline Keogh

    What do these people  mean by'' hookworms work ing''?

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    Jim Chris
    15 hours ago, sunny2012 said:

    "reduction in gluten-induced damage to their intestinal villi"

    REDUCTION in damage. Those who got the drug and participated in the gluten challenge had LESS damage than those who got the placebo.  

    How much less?
    How much damage are those of us who have celiac supposed to accept as normal?
    What makes anyone think that damage to this critical part of the body is ever acceptable?

    How much of the small bowel was tested?
    How can we be certain that serious damage did not happen beyond the part of the small bowel that can be tested?

    What was the criteria for this measurement?

    Celiac nearly killed me before I was diagnosed. Please give me one reason why I would trust "LESS DAMAGE" as an acceptable measure compared to sticking with a 100% gluten free diet?

    I too am skeptical but glad research is being done attempting to find something that works. On the other hand, I have adapted my diet around my celiac and avoiding gluten is working for me. There are many foods that I miss but it is what it is. 

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    trents
    3 hours ago, Caroline Keogh said:

    What do these people  mean by'' hookworms work ing''?

    Working to reverse celiac disease. The idea is that hookworms were a natural part of gut biome balance in premodern times. Supposedly, the hookworms produce regulatory compounds that keep our immune systems healthy. In modern times we have largely eliminated hook worm infections and removed their regulatory benefit. Supposedly, this is a contributing factor to developing celiac disease. There are some scientific studies to support this but at this time it is still considered to be fringe therapy.

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    dixonpete
    3 hours ago, Caroline Keogh said:

    What do these people  mean by'' hookworms work ing''?

    Hookworms modify the immune systems' behavior to protect themselves in the gut. The argument is that in the history of the human species hookworms would have always been there, and as such would be a defacto component of the human immune system. Remove them and things can go haywire. That's the theory at least.

    I was about to undergo surgery for my ulcerative colitis to get a bag when I decided to try it. I bought hookworm larvae off the Internet and applied them to my skin. Within a month or two they resolved both my colitis and my celiac disease. Both are in full remission. I could bathe in gluten now if I wanted.

    The problem is my degree of success is an outlier. For most people it takes longer and the degree of success is less. For some people they get no results at all. Still, for others like myself it's been a miracle cure. 

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    Russ H
    6 hours ago, dixonpete said:

    Hookworms modify the immune systems' behavior to protect themselves in the gut. The argument is that in the history of the human species hookworms would have always been there, and as such would be a defacto component of the human immune system. Remove them and things can go haywire. That's the theory at least.

    I was about to undergo surgery for my ulcerative colitis to get a bag when I decided to try it. I bought hookworm larvae off the Internet and applied them to my skin. Within a month or two they resolved both my colitis and my celiac disease. Both are in full remission. I could bathe in gluten now if I wanted.

    The problem is my degree of success is an outlier. For most people it takes longer and the degree of success is less. For some people they get no results at all. Still, for others like myself it's been a miracle cure. 

    Have you been clinically diagnosed with coeliac disease by blood serum antibody testing and intestinal biopsy? If so, have you had follow up testing since you applied the larvae to your skin? Did you develop a skin rash and have you had stool testing to establish that you are actually hosting hookworm?

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    dixonpete

    I've told this story before here, but I guess it bears repeating.

    For two years straight I was sick multiple times a day was catastrophic diarrhea. Towards the end I was hitting over 10x a day. I rarely left my apartment and was considering suicide. My GP wasn't any help. One day after getting sick after a sandwich I finally figured out the association. The diarrhea stopped the next day but the blood and mucus took a good six months+ to resolve. I also had colitis which complicated things but having the diarrhea stop was fantastic.

    I refused to take the biopsy because I wasn't willing to restart eating gluten. Whenever I was accidentally exposed I got terribly sick. Turned out my aunt and cousin were both celiacs with the same symptoms. That was good enough for me. This was in 2008.

    Probably 20x I was glutened btw 2008 and 2018 till when I started doing hookworms. Horrible, incapacitating reactions - accidental exposures with a good reason for being fooled each time. The colitis remained terrible. Lots of screaming. Turned out eating meat and nuts caused most of that.

    The rash for the hookworm entry is awesome. It looks horrible and blistery but heals without a scar. I've got a new shipment coming in in a couple of weeks and this time I'm going to try using some antihistamine cream. I'm never had a stool test but I did have a colony collapse once and saw a whole bunch of worm carcasses in my stool. I use 25 Necator americanus at a time.

    It's been a night and day difference since I've been on hookworms. No colitis unless I eat pistachios. I'm still lactose intolerant but other than that I have no food limitations. Bread with most meals.

    I've got a guy I email 2x a year and pay him by PayPal. An envelope with the larvae gets shipped out by courier.

    It bears repeating. Sometimes hookworms work for celiac disease, more often though gluten reactions are simply less. I lucked out. Crohn's and ulcerative colitis tend to do better with hookworms. Maybe it was because I had both celiac and colitis I did so well on them, who knows?

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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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