(February 21, 2008 - Insidermedicine) Combining drugs that suppress the immune system is more effective than the current standard practice of using the drugs in sequence for helping patients newly diagnosed with Crohn’s disease obtain remission, according to research published in The Lancet.

Here are some facts about Crohn’s disease:

•    It is an inflammatory disorder of the gastrointestinal tract that occurs when the body’s immune system is overactive in this part of the body.

•    Steroid drugs, which suppress the immune system, are a common treatment for Crohn’s disease, but many people become resistant or dependent on them.

•    Long-term use of steroid drugs is not ideal because they can cause several severe side effects, including a condition known as Cushing’s syndrome, which can lead to serious conditions, such as diabetes, bone fractures, and high blood pressure.

Researchers from Imelda General Hospital randomly divided 133 patients with Crohn’s from medical centers in Belgium, Holland, and Germany into one of two groups. The first group received a fixed program of both the immune suppressing drugs infliximab and azathioprine. They also received additional infliximab as well as steroid drugs as needed to control their symptoms. The second group received steroid drugs followed by azathioprine and infliximab given in sequence, according to current standard protocols.

After six months, 60% of the patients in the combined treatment group had their Crohn’s disease in remission, without needing to resort to surgery or use of steroid drugs. Only 36% of patients in the sequential drug treatment group achieved this same remission. These results were similar after patients in both groups remained on their respective treatments for one year. Rates of serious adverse events were similar in both groups.

Today’s research highlights how the standard protocol for treating Crohn’s disease may soon need to be changed. Mounting evidence is suggesting that giving a combination of immune suppressing drugs to newly diagnosed patients upfront is a more successful strategy than the current standard practice of administering them one-at-a-time.

For Insidermedicine in Depth, I'm Dr. Susan Sharma.