Celiakia
Leczenie

Celiakia jest przewlekłą chorobą autoimmunologiczną, w której jedynym skutecznym leczeniem jest ścisła, dożywotnia dieta bezglutenowa eliminująca pszenicę, jęczmień, żyto oraz ich pochodne. Dieta ta pozwala na regenerację kosmków jelitowych i przywrócenie prawidłowego wchłaniania składników odżywczych, co u dzieci następuje zwykle w ciągu 3-6 miesięcy, a u dorosłych nawet do 2 lat. Monitorowanie leczenia obejmuje coroczne wizyty kontrolne, badania serologiczne przeciwciał specyficznych dla celiakii oraz w razie potrzeby biopsję jelita cienkiego. Suplementacja niedoborów mikro- i makroelementów (m.in. żelazo, witaminy B12, D, K, kwas foliowy, cynk, miedź) powinna być prowadzona pod nadzorem specjalistów. W przypadku opryszczkowatego zapalenia skóry stosuje się dapson (50-100 mg/dobę) jako leczenie uzupełniające do diety bezglutenowej.

  1. Leczenie celiakii – ogólne zasady
    1. Dieta bezglutenowa – podstawa leczenia
    2. Suplementacja w celiakii
  2. Monitorowanie leczenia celiakii
    1. Rola wielodyscyplinarnego zespołu
  3. Leczenie szczególnych postaci celiakii
    1. Leczenie opryszczkowatego zapalenia skóry (dermatitis herpetiformis)
    2. Leczenie celiakii opornej na leczenie (refractory celiac disease)
  4. Nowe metody leczenia celiakii
    1. Główne kierunki rozwoju nowych terapii
    2. Perspektywy nowych terapii
  5. Aspekty psychospołeczne leczenia celiakii
  6. Podsumowanie leczenia celiakii
    1. Kolejne rozdziały

Leczenie celiakii – ogólne zasady

Celiakia (choroba trzewna) jest przewlekłą chorobą autoimmunologiczną, w której organizm reaguje nieprawidłowo na gluten, białko zawarte w pszenicy, życie i jęczmieniu. Obecnie jedynym skutecznym i bezpiecznym leczeniem celiakii jest ścisła, trwająca całe życie dieta bezglutenowa12. Eliminacja glutenu z diety umożliwia ustąpienie stanu zapalnego w jelicie cienkim, co prowadzi do regeneracji kosmków jelitowych i przywrócenia prawidłowego wchłaniania składników odżywczych11.

Przestrzeganie diety bezglutenowej przynosi poprawę u większości pacjentów z celiakią w ciągu kilku dni do kilku tygodni od jej wprowadzenia1. U dzieci proces gojenia błony śluzowej jelita cienkiego przebiega szybciej (zazwyczaj 3-6 miesięcy) niż u dorosłych, u których pełna regeneracja może trwać nawet do 2 lat22. Regularne wizyty kontrolne oraz monitorowanie objawów pod nadzorem specjalisty są kluczowe dla skutecznego leczenia celiakii1.

Dieta bezglutenowa – podstawa leczenia

Dieta bezglutenowa jest podstawowym elementem leczenia celiakii. Wymaga całkowitego wyeliminowania z jadłospisu produktów zawierających pszenicę, jęczmień, żyto oraz ich pochodne11. Zgodnie z regulacjami, żywność oznaczona jako bezglutenowa nie może zawierać więcej niż 20 mg/kg glutenu2. Przestrzeganie ścisłej diety bezglutenowej jest niezbędne, ponieważ nawet niewielkie ilości glutenu mogą powodować uszkodzenie błony śluzowej jelita, nawet jeśli nie wywołują widocznych objawów11.

Po diagnozie celiakii pacjent powinien zostać skierowany do dietetyka specjalizującego się w celiakii, który pomoże w dostosowaniu diety do indywidualnych potrzeb11. Dietetyk udziela porad dotyczących:

  • Identyfikacji ukrytych źródeł glutenu w żywności
  • Planowania zbilansowanych posiłków
  • Czytania etykiet produktów spożywczych, leków i suplementów
  • Robienia zakupów spożywczych
  • Jedzenia poza domem i podczas podróży

12

Warto podkreślić, że gluten nie jest niezbędnym składnikiem diety i może być zastąpiony innymi produktami1. Wiele pokarmów, takich jak mięso, warzywa, sery, ziemniaki i ryż, naturalnie nie zawiera glutenu i można je bezpiecznie włączyć do diety1.

Suplementacja w celiakii

U pacjentów z celiakią często występują niedobory składników odżywczych spowodowane upośledzonym wchłanianiem w jelicie cienkim1. Najczęściej obserwuje się niedobory błonnika, żelaza, wapnia, magnezu, cynku, kwasu foliowego, niacyny, ryboflawiny, witaminy B12 i witaminy D, a także kalorii i białka1. W zależności od nasilenia niedoborów, lekarz może zalecić suplementację12.

Najczęściej zalecane suplementy w celiakii to:

  • Miedź
  • Kwas foliowy
  • Żelazo
  • Witamina B-12
  • Witamina D
  • Witamina K
  • Cynk

1

Suplementacja powinna być prowadzona pod nadzorem lekarza i dietetyka, a niedobory powinny ustąpić wraz z gojenizm się błony śluzowej jelita2. W przypadku ciężkich objawów i znaczących niedoborów, może być konieczna suplementacja parenteralna, a w wyjątkowych przypadkach całkowite żywienie pozajelitowe1.

Monitorowanie leczenia celiakii

Skuteczność leczenia celiakii wymaga regularnego monitorowania i kontroli medycznej1. Pacjent powinien odbywać coroczne wizyty kontrolne, podczas których lekarz ocenia wzrost i masę ciała, analizuje objawy oraz ocenia stosowanie diety bezglutenowej1. Monitorowanie obejmuje:

  • Regularne badania laboratoryjne, w tym oznaczenie przeciwciał specyficznych dla celiakii, które powinny normalizować się w ciągu 6-12 miesięcy od wprowadzenia diety bezglutenowej2
  • Ocenę stanu odżywienia i ewentualnych niedoborów składników odżywczych3
  • Kontrolne badanie endoskopowe z biopsją jelita cienkiego po 1-2 latach stosowania diety bezglutenowej, szczególnie w przypadku braku odpowiedniej odpowiedzi klinicznej lub nawrotu objawów21

Europejskie Towarzystwo Badań nad Celiakią (ESsCD) zaleca, aby kontrola stosowania diety bezglutenowej opierała się na połączeniu wywiadu i badań serologicznych2. Kontrola biopsyjna jest zalecana w przypadku braku odpowiedzi klinicznej lub nawrotu objawów pomimo stosowania diety bezglutenowej2.

Rola wielodyscyplinarnego zespołu

Kompleksowe leczenie celiakii wymaga współpracy wielodyscyplinarnego zespołu, składającego się z gastroenterologa, dietetyka, a w niektórych przypadkach również psychologa lub psychiatry42. Każdy specjalista odgrywa ważną rolę w procesie leczenia:

  • Gastroenterolog – diagnozuje, monitoruje postępy leczenia i dokonuje oceny gojenia się błony śluzowej jelita
  • Dietetyk – pomaga w dostosowaniu diety bezglutenowej i zapewnieniu odpowiedniego odżywiania
  • Psycholog – wspiera pacjenta w radzeniu sobie z psychologicznymi aspektami choroby przewlekłej, takimi jak depresja i lęk21

Wsparcie psychologiczne może być szczególnie istotne dla pacjentów z celiakią, ponieważ przestrzeganie ścisłej diety bezglutenowej przez całe życie może być wyzwaniem i wpływać na jakość życia1. Techniki psychologiczne, takie jak terapia poznawczo-behawioralna, terapie relaksacyjne, biofeedback i terapie oparte na uważności, mogą pomóc w adaptacji do życia z celiakią1.

Leczenie szczególnych postaci celiakii

Leczenie opryszczkowatego zapalenia skóry (dermatitis herpetiformis)

Opryszczkowate zapalenie skóry (dermatitis herpetiformis) jest skórną manifestacją celiakii, charakteryzującą się swędzącą, pęcherzykową wysypką2. Leczenie tej postaci celiakii obejmuje:

  • Podstawowe leczenie dietą bezglutenową, która prowadzi do remisji zmian skórnych, choć efekt może być widoczny dopiero po dłuższym czasie2
  • Leczenie farmakologiczne – najczęściej stosuje się dapson (dawka początkowa zwykle 50-100 mg/dobę), który skutecznie łagodzi świąd i wysypkę, ale nie leczy zmian w jelicie cienkim11
  • W niektórych przypadkach alternatywnie można stosować sulfapirydynę1

Chociaż leki mogą łagodzić swędzenie, jedynie ścisła dieta bezglutenowa może doprowadzić do remisji opryszczkowatego zapalenia skóry2.

Leczenie celiakii opornej na leczenie (refractory celiac disease)

Celiakia oporna na leczenie (refractory celiac disease, RCD) to rzadka forma choroby, w której objawy i uszkodzenie jelita cienkiego utrzymują się lub nawracają, pomimo ścisłego przestrzegania diety bezglutenowej przez co najmniej 6-12 miesięcy21. Wyróżnia się dwa typy celiakii opornej:

  • Typ I – charakteryzuje się normalną populacją limfocytów śródnabłonkowych
  • Typ II – charakteryzuje się obecnością aberrantnej, klonalnej populacji limfocytów śródnabłonkowych2

Diagnostyka celiakii opornej wymaga wykluczenia innych przyczyn utrzymujących się objawów, takich jak nierozpoznana kontaminacja glutenem, inne choroby zapalne jelit, niewydolność trzustki, zaburzenia czynnościowe jelit czy przerost bakteryjny jelita cienkiego2.

Leczenie celiakii opornej obejmuje:

Leczenie typu I RCD:
  • Kortykosteroidy (pierwsza linia leczenia) – najczęściej budezonid w postaci otwartej kapsułki (nie o powolnym uwalnianiu) w dawce 3 mg 3 razy dziennie przez co najmniej 3 miesiące2
  • Leki immunosupresyjne (druga linia leczenia) – tiopuryny, takie jak azatiopryna22
  • W niektórych przypadkach mesalazyna – lek przeciwzapalny stosowany w leczeniu chorób zapalnych jelit1
Leczenie typu II RCD:
  • Chemioterapia z użyciem kladrybiny (pierwsza linia leczenia)2
  • Autologiczny przeszczep komórek macierzystych szpiku kostnego (w przypadkach opornych na inne metody leczenia)23

Pacjenci z celiakią oporną wymagają kompleksowej oceny stanu odżywienia i korekcji niedoborów makro- i mikroelementów za pomocą suplementów doustnych i/lub wsparcia żywieniowego dojelitowego3. W przypadku ciężkiego niedożywienia spowodowanego zaburzeniami wchłaniania można rozważyć żywienie pozajelitowe3.

Niezwykle istotne jest regularne monitorowanie pacjentów z celiakią oporną przez zespół wielodyscyplinarny, obejmujący gastroenterologów i dietetyków, w celu oceny odpowiedzi klinicznej i histologicznej na leczenie4.

Nowe metody leczenia celiakii

Intensywne badania naukowe prowadzone w ostatnich latach przyniosły znaczący postęp w zrozumieniu mechanizmów patogenetycznych celiakii i identyfikacji potencjalnych celów terapeutycznych2. Obecnie trwają liczne badania kliniczne nad nowymi metodami leczenia celiakii, które mogłyby uzupełnić lub zastąpić dietę bezglutenową12.

Główne kierunki rozwoju nowych terapii

Nowe podejścia terapeutyczne w celiakii koncentrują się na trzech głównych obszarach3:

  1. Zmniejszenie ekspozycji na gluten
  2. Modyfikacja przepuszczalności jelitowej
  3. Modulacja aktywacji układu immunologicznego
Terapie enzymatyczne

Terapie enzymatyczne mają na celu rozkład glutenu w przewodzie pokarmowym przed jego wchłonięciem, co mogłoby zapobiec uszkodzeniu jelita1. Do najbardziej zaawansowanych w badaniach klinicznych należą:

  • Latiglutenaza (IMGX003) – mieszanina dwóch enzymów specyficznych dla glutenu, które rozkładają białka glutenowe na małe, nieszkodliwe fragmenty41. W badaniach fazy 2 wykazano, że latiglutenaza zapobiega degradacji błony śluzowej i rozwojowi objawów w wyniku zanieczyszczenia glutenem2.
  • TAK-062 (Kuma062) – firma Takeda prowadzi badanie fazy 2 oceniające skuteczność i bezpieczeństwo TAK-062 w leczeniu aktywnej celiakii u osób próbujących stosować dietę bezglutenową5.
  • E40 – doustny enzym opracowywany przez firmę Enteralia, który skutecznie rozkłada gluten nawet przy braku pepsyny2.
Terapie modulujące przepuszczalność jelitową

Modulacja przepuszczalności jelitowej ma na celu zapobieganie przechodzeniu peptydów glutenowych przez nabłonek jelitowy do blaszki właściwej3. Przykładem jest:

  • Larazotid octan – reguluje połączenia ścisłe między komórkami nabłonka jelitowego, zmniejszając przepuszczalność jelita dla glutenu2.
Terapie immunomodulacyjne

Terapie immunomodulacyjne mają na celu zapobieganie lub modulowanie odpowiedzi immunologicznej na gluten3. Przykłady obejmują:

  • KAN-101 – działa poprzez reedukację limfocytów T, aby nie reagowały na antygeny glutenowe4. W badaniu fazy 1b/2 (ACeD-it) wykazano, że KAN-101 jest bezpieczny i dobrze tolerowany przy wyższych poziomach dawek, a także zaobserwowano funkcjonalną tolerancję na gluten1.
  • Amlitelimab – przeciwciało monoklonalne podawane podskórnie, skierowane przeciwko OX40L. Firma Sanofi prowadzi badanie fazy 2a/b oceniające skuteczność i bezpieczeństwo amlitelimabu u dorosłych uczestników z celiakią niereagującą na dietę bezglutenową41.
  • TAK-101 – Takeda prowadzi badanie fazy 2 mające na celu dalsze zbadanie potencjału TAK-101 w leczeniu pacjentów z celiakią stosujących dietę bezglutenową5.
  • TAK-227 – w badaniu proof-of-concept fazy 2a z prowokacją glutenem wykazano, że TAK-227 skutecznie zmniejszał uszkodzenie błony śluzowej dwunastnicy wywołane przez gluten u osób z celiakią5.
Inne podejścia terapeutyczne

Inne obiecujące podejścia terapeutyczne obejmują:

  • Inhibitory transglutaminazy tkankowej (TG2) – ZED1227 jest inhibitorem TG2, który w badaniach wykazał, że zapobiega uszkodzeniu jelita wywołanemu przez gluten12. Badania potwierdziły, że doustnie podawany ZED1227 skutecznie zapobiega uszkodzeniu błony śluzowej jelita i stanowi zapalnego wywołanego przez gluten2.
  • Blokery HLA-DQ2/DQ8 – firma IM Therapeutics opracowuje doustny lek małocząsteczkowy, który blokuje funkcję HLA-DQ2, głównego genetycznego czynnika ryzyka celiakii2. Podobnie firma Provid koncentruje się na chemii syntetycznej i medycznej oraz opracowuje inhibitory DQ2 i DQ8, dwóch genów związanych z celiakią3.
  • Tolerogenna szczepionka przeciwko celiakii – badacze pracują nad szczepionkami, które nauczyłyby układ odpornościowy tolerować gluten31. Firma Barinthus Bio opracowuje VTP-1000, iniekcyjną immunoterapię w kierunku tolerancji na gluten, która wykorzystuje platformę SNAP-TI do dostarczania wielu peptydów antygenowych pochodzących z glutenu i immunomodulatora rapamycyny w nanocząstkach w celu promowania tolerancji immunologicznej na gluten2.

Perspektywy nowych terapii

Choć nowe metody leczenia celiakii są w różnych fazach badań klinicznych, żadna z nich nie została jeszcze zatwierdzona do rutynowego stosowania w praktyce klinicznej2. Większość opracowywanych terapii ma stanowić uzupełnienie diety bezglutenowej, a nie jej zastąpienie2.

Terapie indukujące tolerancję immunologiczną na gluten mają największy potencjał, aby umożliwić ponowne wprowadzenie glutenu do diety2. Jednakże, do czasu pojawienia się dalszych badań dotyczących stosowania nowych terapii w rutynowej praktyce klinicznej, ścisłe przestrzeganie diety bezglutenowej pozostaje podstawowym leczeniem celiakii2.

Aspekty psychospołeczne leczenia celiakii

Leczenie celiakii wykracza poza aspekty medyczne i dietetyczne, obejmując również wsparcie psychospołeczne2. Przestrzeganie ścisłej diety bezglutenowej przez całe życie może być wyzwaniem i wpływać na jakość życia pacjenta1.

Ważne aspekty psychospołeczne leczenia celiakii obejmują:

  • Edukację pacjenta i rodziny na temat choroby i diety bezglutenowej1
  • Wsparcie psychologiczne w adaptacji do życia z chorobą przewlekłą1
  • Udział w grupach wsparcia dla osób z celiakią, które mogą być pomocne w odkrywaniu sposobów radzenia sobie z chorobą oraz dzieleniu się przepisami i źródłami bezglutenowej żywności1
  • Techniki zarządzania stresem i bólem1
  • Wsparcie w szkole lub miejscu pracy2

Metody psychoterapeutyczne, takie jak terapia poznawczo-behawioralna, terapie relaksacyjne, biofeedback i terapie oparte na uważności, mogą pomóc pacjentowi i rodzinie w dostosowaniu się do życia z celiakią1.

Podsumowanie leczenia celiakii

Celiakia jest chorobą autoimmunologiczną, którą można skutecznie leczyć poprzez ścisłe przestrzeganie diety bezglutenowej przez całe życie1. Odpowiednie leczenie pozwala na regenerację błony śluzowej jelita cienkiego, ustąpienie objawów i zapobieganie długoterminowym powikłaniom1.

Kompleksowe leczenie celiakii obejmuje:

  • Ścisłą, dożywotnią dietę bezglutenową jako podstawę leczenia1
  • Suplementację niedoborów witamin i składników mineralnych1
  • Regularne monitorowanie stanu zdrowia i odpowiedzi na leczenie1
  • W przypadku szczególnych form celiakii, takich jak opryszczkowate zapalenie skóry czy celiakia oporna, stosowanie odpowiedniego leczenia farmakologicznego12
  • Wsparcie psychospołeczne w adaptacji do życia z chorobą przewlekłą2

Choć obecnie trwają intensywne badania nad nowymi metodami leczenia celiakii, dieta bezglutenowa pozostaje jedyną naukowo potwierdzoną, skuteczną i bezpieczną terapią2. Prawidłowe leczenie celiakii wymaga współpracy wielodyscyplinarnego zespołu specjalistów oraz aktywnego zaangażowania pacjenta w proces terapeutyczny4.

Kolejne rozdziały

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Future Therapies | Celiac Disease FoundationBack to HomeBack to HomeAbout the DiseaseGluten-Free ResourcesResearch ResourcesAdvocacy and Public PolicyJoin the EffortSupport the FoundationShare on FacebookShare on TwitterEmail this pageprinter-miniRelated
    https://celiac.org/about-celiac-disease/future-therapies-for-celiac-disease/
    Currently, the only available treatment for a patient with celiac disease is a strict gluten-free diet. A lifelong diet completely free of gluten can be very costly and challenging. Many patients’ intestines don’t heal completely, and they continue to suffer from symptoms, most often due to imperfect adherence to the gluten-free diet. […] Future drug therapies are currently in development with the hope of reducing the burden of living with celiac disease and improving long-term health outcomes. […] Allero is currently developing their lead product for the treatment of celiac disease. […] AMYRA is a biotech company that is developing a novel enzyme-based treatment for celiac disease. […] AnTolRx is a biotechnology company focused on revolutionizing the treatment of autoimmune diseases, including celiac disease.
  • #1
    https://www.nhs.uk/conditions/coeliac-disease/treatment/
    Coeliac disease is treated by excluding foods that contain gluten from your diet. […] If you have coeliac disease, you must stop eating all sources of gluten for life. Your symptoms will return if you eat foods containing gluten, and it will cause long-term damage to your health. […] A GP will offer you an annual review during which your height and weight will be measured and your symptoms reviewed. They’ll also ask you about your diet and assess whether you need any further help or specialist nutritional advice. […] When you’re first diagnosed with coeliac disease, you’ll be referred to a dietitian to help you adjust to your new diet without gluten. […] Gluten is not essential in your diet and it can be replaced by other foods. […] Many foods, such as meat, vegetables, cheese, potatoes and rice, are naturally free from gluten so you can still include them in your diet.
  • #1 Celiac Disease: Symptoms & How It’s Treated
    https://my.clevelandclinic.org/health/diseases/14240-celiac-disease
    The first and most important step in treating celiac disease is to stop eating gluten. You cant change the way your body reacts to gluten, but you can prevent gluten from triggering that reaction. When you stop eating gluten, your small intestine will begin to heal and will soon be able to absorb nutrients again. You have to maintain a strict gluten-free diet for life, though, to avoid hurting your small intestine again. […] Additional treatment may include: Nutritional supplements to replace any serious deficiencies. Specific medications to treat dermatitis herpetiformis, such as dapsone. Corticosteroids for severe inflammation thats not responding fast enough to the diet. Continuous follow-up care, including regular testing to make sure the disease is controlled. […] Most people find their symptoms begin to improve almost immediately after starting a gluten-free diet. It may take several weeks to replace your nutritional deficiencies and several months for your gut to fully heal. It can take longer in some cases, depending on the extent of the damage and how long its been going on. You can also delay healing if you arent strict with your diet.
  • #1 Treatment for Celiac Disease – NIDDK
    https://www.niddk.nih.gov/health-information/digestive-diseases/celiac-disease/treatment
    Doctors treat celiac disease by helping people to follow a gluten-free diet. Symptoms greatly improve for most people with celiac disease who stick to a gluten-free diet. For most people, following a gluten-free diet will heal damage in the small intestine and prevent more damage. Your doctor will explain the gluten-free diet and may refer you to a registered dietitian who specializes in treating people who have celiac disease. A gluten-free diet will treat or prevent many of the symptoms and complications of celiac disease. In untreated celiac disease, damage to the small intestine can lead to malabsorption and malnutrition. When you are diagnosed with celiac disease, your doctor may test you for low levels of certain vitamins and minerals and may recommend or prescribe supplements if you need them. Your doctor may recommend regular follow-up visits to make sure symptoms and health problems related to celiac disease are improving on a gluten-free diet. If you continue to have celiac disease symptoms while you are following a gluten-free diet, talk with your doctor or a registered dietitian, who can help you find the cause. Refractory celiac disease is a rare condition in which symptoms and damage to the small intestine continue or come back, even while a person is following a strict gluten-free diet. Doctors may recommend additional testing and treatments to diagnose and manage refractory celiac disease.
  • #1 Treatment & Follow-Up | Celiac Disease FoundationBack to HomeBack to HomeAbout the DiseaseGluten-Free ResourcesResearch ResourcesAdvocacy and Public PolicyJoin the EffortSupport the FoundationShare on FacebookShare on TwitterEmail this pageprinter-miniarr
    https://celiac.org/about-celiac-disease/treatment-and-follow-up/
    Lifelong Adherence to the Gluten-Free Diet The only treatment for celiac disease is to follow a strict gluten-free diet for life. This means avoiding foods and beverages that gluten, a protein found in wheat, rye, barley, and triticale (a hybrid of wheat and rye). […] Vitamins and Dietary Supplements Commonly, people with celiac disease are deficient in fiber, iron, calcium, magnesium, zinc, folate, niacin, riboflavin, vitamin B12, and vitamin D, as well as in calories and protein. […] Medication Medication is not normally required except in some cases of dermatitis herpetiformis, in which medication such as dapsone or sulfapyridine is administered for a short period of time to control the rash. […] Physician Follow-Up At Time of Diagnosis At time of diagnosis, your physician should: Recommend a dietitian expert in celiac disease and the gluten-free diet to provide education and counseling. […] Dietitian Follow-Up At Time of Diagnosis At time of diagnosis, your dietitian should: Provide gluten-free dietary counseling, including education on the inclusion of oats, cross-contamination, and label-reading for foods, medications and supplements.
  • #1 Celiac disease – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/celiac-disease/diagnosis-treatment/drc-20352225
    A strict, lifelong gluten-free diet is the only way to manage celiac disease. […] A dietitian who works with people with celiac disease can help you plan a healthy gluten-free diet. Even trace amounts of gluten in your diet can be damaging, even if they don’t cause symptoms. […] Removing gluten from your diet will typically reduce inflammation in your small intestine, causing you to feel better and eventually heal. Children tend to heal more quickly than adults. […] If your anemia or nutritional deficiencies are severe, supplements may be recommended, including: Copper, Folic acid, Iron, Vitamin B-12, Vitamin D, Vitamin K, Zinc. […] Medical follow-up at regular intervals can ensure that your symptoms have responded to a gluten-free diet. […] For most people with celiac disease, eating a gluten-free diet allows the small intestine to heal.
  • #1 Celiac Disease Treatment | BeyondCeliac.org
    https://www.beyondceliac.org/celiac-disease/treatment/
    There is no cure for celiac disease, which is a life-long autoimmune condition. However, there is a treatment that can relieve symptoms: eating gluten-free. […] Every patient diagnosed with celiac disease will be instructed to eat gluten-free for the rest of their life. Some may also be prescribed nutritional supplements, and patients with dermatitis herpetiformis, a skin rash associated with celiac disease, may be prescribed dapsone or another drug to relieve itching. Patients with refractory celiac disease, a rare and aggressive form of the condition, may be put on immunosuppressants to calm the immune system. […] Currently, the only treatment for celiac disease is a lifelong gluten-free diet. Even small amounts of gluten can damage the intestine in those with celiac disease, so people with celiac disease don’t have “cheat days.”
  • #1 Celiac Disease: Diagnosis and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0115/p99.html
    Celiac disease is an autoimmune disorder of the gastrointestinal tract triggered by exposure to dietary gluten in genetically susceptible individuals. […] Treatment of celiac disease is a gluten-free diet. Dietary education should focus on identifying hidden sources of gluten, planning balanced meals, reading labels, food shopping, dining out, and dining during travel. […] A gluten-free diet improves the quality of life in those with symptomatic celiac disease. […] About 5% of patients with celiac disease are refractory to a gluten-free diet. These patients should be referred to a gastroenterologist for reconsideration of the diagnosis or for aggressive treatment of refractory celiac disease, which may involve corticosteroids and immunomodulators. […] Removing the antigenic substance responsible for the abnormal immune reaction typically reverses the manifestations of celiac disease. Therefore, treatment is a lifelong gluten-free diet.
  • #1 Azthena logo with the word Azthena
    https://www.news-medical.net/health/Celiac-Disease-Treatment.aspx
    At present there is no cure or specific medicinal treatment for celiac disease. The present treatment of celiac disease revolves around making the diet completely free of gluten that induces hypersensitivity and brings on symptoms. […] In patients with celiac disease, gluten free diet must be adhered to for life. Primarily wheat, barley, and rye are avoided. […] The initial approach is to prepare natural and gluten free diets with the help of a diet advisor or support groups. […] Patients are advised to take high iron and folate containing foods. […] A gluten-free diet is typically low in fibre. Patients should be advised to eat a high-fibre diet supplemented with whole-grain rice, maize, and vegetables. […] The response to a gluten-free diet in terms of improvement in symptoms is rapid among most patients (within 2 weeks). The rate of response varies between patients. The quality of life significantly improves on a gluten-free diet with marked improvement in symptoms. […] Patients presenting with severe symptoms need hospital admission along with intravenous fluid supplementation, electrolytes administration, parenteral nutrition and occasionally, steroids.
  • #1 Celiac Disease – Gastrointestinal Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/gastrointestinal-disorders/malabsorption-syndromes/celiac-disease
    Treatment of celiac disease is a gluten-free diet (avoiding foods containing wheat, rye, or barley). Gluten is widely used in commercially prepared foods, so patients need a detailed list of foods to avoid. Patients are encouraged to consult a dietitian and join a celiac support group as well (English-language groups include Beyond Celiac or the Celiac Disease Foundation). The response to a gluten-free diet is usually rapid, and symptoms resolve in 1 to 2 weeks. Ingesting even small amounts of food containing gluten, however, may prevent remission or induce relapse. […] Small-bowel biopsy should be repeated after 3 to 6 months of a gluten-free diet. If abnormalities persist, other causes of villous atrophy (eg, lymphoma) should be considered. Lessening of symptoms and improvement in small-bowel morphology are accompanied by a decrease in anti-tissue transglutaminase antibody and anti-endomysial antibody titers.
  • #1 Celiac Disease Psychosocial Services – Stanford Medicine Children’s Health
    https://www.stanfordchildrens.org/en/services/celiac-disease/psychosocial-services.html
    Celiac disease affects not only your child but also your entire family. […] Our celiac disease team is here to support you and your family as you navigate a celiac disease diagnosis and learn ways to cope with stress related to living gluten free. […] This evaluation leads to individualized treatment recommendations, including techniques for stress and pain management, treatment adherence, school support, supportive counseling with the social worker and psychologist, celiac disease support groups, peer-to-peer support, and/or additional support through individual and family therapy in the community. […] A variety of psychological techniques and interventions are available to help your child and family adjust to celiac disease. […] Treatment modalities include cognitive behavioral therapy, relaxation-based therapies, biofeedback, and mindfulness-based treatments.
  • #1 Celiac disease: Symptoms, diagnosis, diet, and treatment
    https://www.medicalnewstoday.com/articles/38085
    Most people find that eliminating gluten from their diets greatly improves their symptoms. It allows the intestine to heal. […] If a person has dermatitis herpetiformis, medications such as diamino diphenyl sulfone (Dapsone) can reduce the symptoms. However, this does not heal the intestine, so a gluten-free diet is still crucial. […] People with celiac disease may also benefit from taking vitamin and mineral supplements to help prevent or address deficiencies. […] Researchers continue to work on drug therapies to reduce the challenges of living with celiac disease and improve the long-term outlook. The Celiac Disease Foundation offers more information about possible future treatments.
  • #1 Celiac disease – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220
    There’s no definite cure for celiac disease. But for most people, following a strict gluten-free diet can help manage symptoms and help the intestines heal. […] Health care professionals treat dermatitis herpetiformis with a gluten-free diet or medicine, or both, to control the rash. […] Nonresponsive celiac disease is often due to contamination of the diet with gluten. Working with a dietitian can help you learn how to avoid all gluten. […] In rare instances, the intestinal injury of celiac disease doesn’t respond to a strict gluten-free diet. This is known as refractory celiac disease. If you still have symptoms after following a gluten-free diet for 6 months to 1 year, you should talk to your health care team to see if you need further testing to look for explanations for your symptoms.
  • #1 Old and New Adjunctive Therapies in Celiac Disease and Refractory Celiac Disease: A Review
    https://www.mdpi.com/1422-0067/24/16/12800
    Celiac disease (CD) is a chronic enteropathy caused by the ingestion of gluten in a genetically susceptible individual. Currently, a gluten-free diet (GFD) is the only recommended treatment. […] Today, GFD remains the only effective treatment, although steroids, mesalamine, and more recently biological therapies have found space in the complex management of RCD. […] Gluten-Free Diet (GFD) remains the only recommended treatment for celiac disease and usually results in improvement or resolution of enteropathy and symptoms. […] According to the current guidelines, in case of RCD-I, oral budesonide is considered the first-line therapy, while the second-line therapy is represented by immunosuppressants such as thiopurines. […] In RCD-II, chemotherapy with cladribine and autologous haematopoietic stem cell transplantation are considered the first-line therapy.
  • #1 Drugs for Celiac Disease May Be on the Horizon | Columbia University Irving Medical Center
    https://www.cuimc.columbia.edu/news/drugs-celiac-disease-may-be-horizon
    The only safe and effective treatment for celiac disease is to avoid food and drinks that contain gluten, a protein found naturally in wheat, barley, and rye. […] For these reasons, many companies and researchers are looking for drugs to treat celiac disease in addition toor instead ofthe gluten-free diet. […] In the past decade, the landscape of drug therapy for celiac disease has evolved from a mere concept to more than a dozen candidate medications in trials with patients. […] Some of the candidates work by preventing the consequences of accidental gluten exposure. […] For example, latiglutenase is taken with meals and contains enzymes that break down gluten in the stomach, rendering the protein non-toxic to patients with celiac disease. […] A second category of drugs attempts to re-educate the patients immune system so it no longer reacts to gluten.
  • #1 New and Developing Therapies for Celiac Disease
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3002532/
    The treatment for celiac disease, a removal of gluten in the diet, is safe and effective for the vast majority of patients. […] Although a gluten-free diet is the principal treatment for celiac disease, it is relatively expensive, inconvenient and difficult to adhere to. […] Emerging research for the treatment of celiac disease has focused on three areas: to decrease gluten exposure, to modify intestinal permeability and to modulate immune activation. […] Therapies developed thus far consist of enzymes designed to digest gluten and the use of inhibitors of paracellular permeability to decrease the migration of gluten peptides into the lamina propria. […] Other potential therapeutic maneuvers include the binding of gluten by polymers, the use of tissue transglutaminase (TTG) inhibitors and DQ2 or DQ8 blockers, or modulation of cytokine production.
  • #1 New Treatments for Celiac Disease Gain Traction – BioSpace
    https://www.biospace.com/drug-development/opinion-new-treatments-for-celiac-disease-gain-traction
    There are currently no treatments available for celiac disease beyond a gluten-free diet. […] Several companies are working on late-stage investigational treatments to treat celiac disease via a variety of therapeutic approaches. If ultimately approved, these treatments should change care for the disease profoundly by removing the burdensome need for total gluten avoidance. […] The frontrunner, Entero Therapeutics, is researching latiglutenase, an enzyme that breaks down gluten in the stomach. […] In May 2024, Anokion reported results from the Phase Ib/II ACeD-it trials, revealing that KAN-101 was safe and remained well-tolerated at higher dose levels up to 3 mg/kg. In addition, functional tolerance to gluten was observed. […] Elsewhere, Sanofi is enrolling Phase II trials of amlitelimab, an OX40L subcutaneous monoclonal antibody. […] Finally, Takeda is developing three investigational agents to treat celiac disease. […] In conclusion, several investigational treatments are vying to treat celiac disease.
  • #1 New study demonstrates the efficacy of a promising celiac disease drug at the molecular level
    https://medicalxpress.com/news/2024-06-efficacy-celiac-disease-drug-molecular.html
    A recent study led by researchers at Tampere University investigated whether a transglutaminase 2 inhibitor has potential as a drug to treat celiac disease. Previous tissue studies have shown that the ZED1227 transglutaminase 2 inhibitor prevents gluten-induced intestinal damage. […] The results of the new study, based on an analysis of the molecular activity of more than 10,000 genes, provide very strong evidence that the first successful drug to treat celiac disease may be at hand. […] Currently, no drug therapy exists, and a life-long strict gluten-free diet is the only available treatment. However, symptoms and intestinal damage caused by hidden gluten can occur even in patients who are following a strict diet. […] In a previous tissue study coordinated by Professor Emeritus Markku Mäki from Tampere University, the ZED1227 transglutaminase 2 inhibitor was shown to prevent gluten-induced intestinal damage in patients with celiac disease. However, its mechanisms of action are not fully understood yet.
  • #1
    https://penntoday.upenn.edu/news/penn-medicine-pursuing-vaccines-stop-celiac-disease
    Currently, theres no treatment for celiac disease aside from avoiding gluten. […] In a way, we want to use mRNA to induce the opposite response youd want for an infectious disease vaccine, says Melamed. For diseases like COVID, you want to induce an infection-fighting response; for celiac disease, we want to stop the immune response already happening in the body. […] The idea is to make what experts call a tolerizing vaccine, or a vaccine that would allow someones body to tolerate the thing its reacting to; in this case, that would be the gluten protein.
  • #1 Coeliac disease – Wikipedia
    https://en.wikipedia.org/wiki/Coeliac_disease
    The only known effective treatment is a strict lifelong gluten-free diet, which leads to recovery of the intestinal lining (mucous membrane), improves symptoms, and reduces the risk of developing complications in most people. […] Compliance to a strict gluten-free diet is difficult for the patient, but evidence has accumulated that a strict gluten-free diet can result in resolution of diarrhea, weight gain and normalization of nutrient malabsorption, with normalization of biopsies in 6 months to 2 years on a gluten-free diet. […] At present, the only effective treatment is a lifelong gluten-free diet. […] No medication exists that prevents damage or prevents the body from attacking the gut when gluten is present. […] Gluten-free diet improves healthcare-related quality of life, and strict adherence to the diet gives more benefit than incomplete adherence.
  • #1
    https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abp7938
    Celiac disease causes damage to the small intestine. This makes it hard for the body to absorb vitamins and other nutrients. […] But you can stop and reverse the damage to the small intestine by eating a strict gluten-free diet. […] Follow-up care is a key part of your treatment and safety. […] Eat a gluten-free diet to prevent symptoms and damage to the small intestine. Even a small amount of gluten may cause damage. […] You may need to avoid milk and milk products for a while. Once you stop eating any gluten, the intestine will begin to heal. Then it should be okay to drink milk and eat milk products. […] Talk to your doctor or contact your local hospital or dietitian for information about support groups in your area. You may find a support group helpful for discovering ways to help you deal with celiac disease. Celiac disease support groups often share recipes and good food sources. […] Look for gluten-free foods. Many food stores offer specially marked gluten-free food.
  • #2 Celiac disease – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/celiac-disease/diagnosis-treatment/drc-20352225
    A strict, lifelong gluten-free diet is the only way to manage celiac disease. […] A dietitian who works with people with celiac disease can help you plan a healthy gluten-free diet. Even trace amounts of gluten in your diet can be damaging, even if they don’t cause symptoms. […] Removing gluten from your diet will typically reduce inflammation in your small intestine, causing you to feel better and eventually heal. Children tend to heal more quickly than adults. […] If your anemia or nutritional deficiencies are severe, supplements may be recommended, including: Copper, Folic acid, Iron, Vitamin B-12, Vitamin D, Vitamin K, Zinc. […] Medical follow-up at regular intervals can ensure that your symptoms have responded to a gluten-free diet. […] For most people with celiac disease, eating a gluten-free diet allows the small intestine to heal.
  • #2 Celiac Disease: Symptoms, Treatment, and More
    https://www.healthline.com/health/celiac-disease-sprue
    You can talk with a healthcare professional about taking a supplement, such as a multivitamin or an iron supplement. […] Gluten-digesting enzymes are another supplement on the market that may be helpful for non-celiac gluten sensitivity. Claims that these enzymes help people with celiac digest gluten by breaking down the protein have not yet been verified. […] Your symptoms should improve within days to weeks of cutting all gluten out of your diet. In children, the intestine usually heals in 3 to 6 months. Intestinal healing may take several years in adults. Once your intestine completely heals, your body will be able to properly absorb nutrients.
  • #2
    https://www2.hse.ie/conditions/coeliac-disease/treatment/
    By law, food labelled as gluten-free cannot contain more than 20mg/kg of gluten. […] Other treatments include vaccinations, supplements, and medication to treat rashes. […] Your GP or dietitian may recommend vitamin and mineral supplements. This may be for the first 6 months after diagnosis. […] Cutting out gluten should clear it up. […] If refractory coeliac disease is suspected, it’s likely you’ll be referred for tests. This is to make sure your symptoms aren’t caused by another condition. […] If the diagnosis is confirmed, you’ll get a referral to a specialist. Treatment options include steroid medication. These help block the harmful effects of the immune system.
  • #2 Celiac Disease: Diagnosis and Management | AAFP
    https://www.aafp.org/pubs/afp/issues/2014/0115/p99.html
    The dietary threshold to promote healing of intestinal inflammation in celiac disease has been found to be less than 50 mg of gluten per day. […] Dietary education should focus on identifying hidden sources of gluten, planning balanced meals, reading labels, grocery shopping, dining out, and dining during travel. […] An empiric trial of a gluten-free diet without a biopsy is not recommended because symptoms of other disorders can improve in patients following this diet. […] Approximately 95% of patients who follow a gluten-free diet show clinical improvement within days to weeks. […] About 5% of patients with celiac disease are refractory to a gluten-free diet. Those patients should be referred to a gastroenterologist to reconsider the diagnosis or for aggressive treatment of refractory celiac disease, which may require corticosteroids and immunomodulators.
  • #2
    https://www.nhs.uk/conditions/coeliac-disease/treatment/
    As well as eliminating foods that contain gluten from your diet, there are other treatments available for coeliac disease. […] A GP or dietitian may also recommend taking vitamin and mineral supplements if you need them, for example for iron deficiency anaemia. […] If you have dermatitis herpetiformis (an itchy rash that can be caused by gluten intolerance), cutting gluten out of your diet should help. […] If refractory coeliac disease is suspected, it’s likely you’ll be referred for a series of tests to make sure your symptoms are not being caused by another condition. […] If no other cause can be found and the diagnosis is confirmed, you’ll be referred to a specialist. Treatment options include steroid medicine, such as prednisolone, or immunosuppressant medicine, which help block the harmful effects of the immune system.
  • #2 Celiac Disease Treatment | BeyondCeliac.org
    https://www.beyondceliac.org/celiac-disease/treatment/
    While a gluten-free diet is the cornerstone of managing celiac disease, some treatments target the symptoms of this condition. These approaches aim to alleviate discomfort and prevent complications by addressing specific symptoms, such as nutritional deficiencies and skin manifestations. […] Nutritional deficiencies should go away over time as your intestines heal, and your doctor may, after a time, wean you off supplements or injections. […] The most common medication used to treat dermatitis herpetiformis is dapsone. […] While medications can ease itchiness, the only thing that will put dermatitis herpetiformis into remission is a strict, gluten-free diet. […] For patients with refractory celiac disease, the immune system attacks the intestines even on a gluten-free diet. Immunosuppressants can help.
  • #2 Celiac Disease (Sprue) Treatment & Management: Approach Considerations, Medical Care, Probiotics
    https://emedicine.medscape.com/article/171805-treatment
    A small percentage of patients with celiac disease fail to respond to a gluten-free diet. In some patients who are refractory, corticosteroids might be helpful. […] Newly considered treatment approaches for managing celiac disease that are in preclinical and clinical trials include gluten-sequestering agents, wherein patients can eat gluten and the drug sequester specifically, rendering gluten unharmful to the patient. […] Nonresponsive celiac disease is commonly encountered in clinical practice, occurring in most cases due to nonadherence to a gluten-free diet. However, refractory celiac disease is rare; it is caused by gluten-independent autoimmunity (type I) or low grade lymphoma in the epithelium (type II). […] Monitor CD patients regularly for persistent or new symptoms, adherence to a GFD, and assessment for complications. Base monitoring of GFD adherence on a combination of history and serology. […] A follow-up duodenal biopsy is recommended for monitoring in cases of lack of clinical response or relapse of symptoms despite a GFD.
  • #2 Get Celiac Disease Treatment | Cleveland Clinic
    https://my.clevelandclinic.org/services/celiac-disease-treatment
    At Cleveland Clinic, we go beyond getting rid of gluten. We offer whole-person care that helps you improve both physically and emotionally. […] Our experienced dietitians will help you put together a personalized diet plan that meets your nutritional needs and prevents vitamin and mineral deficiencies, like vitamin D. […] While your custom treatment plan sets you up for success, youll still need to see us regularly to check on your small intestine and your overall health. […] Its important to remain gluten-free for life because even a small amount can damage your small intestine and restart all of your problems. […] We know it can be exhausting and stressful to face a chronic issue like celiac disease. Thats why your care team includes mental health professionals who treat depression, anxiety and other conditions.
  • #2 Celiac disease – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/celiac-disease/diagnosis-treatment/drc-20352225
    If your small intestine is severely damaged or you have refractory celiac disease, steroids may be recommended to control inflammation. […] If you have this skin rash, a medicine called dapsone may be recommended in addition to a gluten-free diet. […] With refractory celiac disease, the small intestine doesn’t heal. Refractory celiac disease can be quite serious, and there is currently no proven treatment.
  • #2 Clinical Practice Update: How to manage refractory celiac disease – American Gastroenterological AssociationAGA Logo_Horizontal
    https://gastro.org/news/clinical-practice-update-how-to-manage-refractory-celiac-disease/
    For patients with nonresponsive celiac disease, after exclusion of gluten ingestion, perform a systematic evaluation for other potential causes of symptoms, including functional bowel disorders, microscopic colitis, pancreatic insufficiency, inflammatory bowel disease, lactose or fructose intolerance and small intestinal bacterial overgrowth. […] Use flow cytometry, immunohistochemistry and T-cell receptor rearrangement studies to distinguish between subtypes of refractory celiac disease and to exclude enteropathy-associated T-cell lymphoma. Type 1 refractory celiac disease is characterized by a normal intraepithelial lymphocyte population and type 2 is defined by the presence of an aberrant, clonal intraepithelial lymphocyte population. Consultation with an expert hematopathologist is necessary to interpret these studies.
  • #2 Old and New Adjunctive Therapies in Celiac Disease and Refractory Celiac Disease: A Review
    https://www.mdpi.com/1422-0067/24/16/12800
    Currently, a plethora of phase-II trials have been recently published or are ongoing with promising results. […] The aim of this review is to analyse and discuss the available adjunctive therapies for the treatment of CD and RCD, as well as to present the novel therapies that are emerging in the current literature for the treatment of RCD and the possibilities to consider using them in future clinical practice. […] The current American Gastroenterological Association Guidelines (AGA) recommend corticosteroids as first-line therapy in either type 1 or type 2 refractory celiac disease. […] The most effective medical treatment in RCD I patients are steroids. The first therapeutic steps consist of open capsule/non-slow-release budesonide, 3 mg, 3 times a day, for at least 3 months. […] In case of failure to respond, RCD I misdiagnosis must be excluded and thiopurine dosage may be optimized. […] Currently, auto-stem cell transplantation is indicated only in symptomatic patients and not in asymptomatic patients trying to eliminate aberrant intra-epithelial lymphocytes.
  • #2 Treatment for Refractory Celiac Disease
    https://www.verywellhealth.com/refractory-celiac-disease-treatment-562630
    So your healthcare provider may start your treatment by checking your body’s level of vitamins, minerals, and other nutrients, and prescribing nutritional support to help reverse your malnutrition. […] In a few cases involving Type I disease, nutritional support and a very strict gluten-free diet may be all you need to begin healing. But most people also receive drug treatment. […] To date, drug treatment of refractory celiac disease has focused on therapies designed to suppress your immune system in an effort to give your intestines a break from the relentless autoimmune attack. […] In both Type I and Type II refractory celiac disease, the first-line drug treatment is typically a form of steroid medication known as glucocorticoids. […] Research shows that most people with Type I refractory celiac disease will go into remission, in other words, see their symptoms resolve and their intestines begin to heal through the use of steroids, possibly combined with azathioprine.
  • #2 Current and emerging therapies for coeliac disease | Nature Reviews Gastroenterology & Hepatology
    https://www.nature.com/articles/s41575-020-00378-1
    At present, a gluten-free diet is the only effective treatment for coeliac disease but is associated with several possible challenges, including a high economic and societal burden, inferior quality of life and sometimes inadequate response. […] An increased understanding of the pathogenetic process in coeliac disease has revealed various therapeutic targets for future drugs that could complement or replace a gluten-free diet. […] Novel therapeutic strategies include approaches to detoxify gluten already in the gastrointestinal tract by sequestrants or peptidases. […] Other investigational approaches comprise blocking intestinal epithelial permeability or the enzymatic activity of transglutaminase 2. […] Restoring immune tolerance to gluten or targeting the gluten-induced immune activation has also been investigated as possible therapeutic options. […] The most advanced drug candidates have now entered phase III clinical trials.
  • #2 Who Will Lead the Celiac Disease Treatment Revolution?
    https://www.delveinsight.com/blog/celiac-disease-treatment
    Emerging therapies for celiac disease are focusing on novel approaches to manage or potentially cure the condition, which currently has no pharmacological treatments apart from a strict gluten-free diet. […] Currently, 25+ companies are active in the celiac disease treatment space across the globe, as per DelveInsights Celiac Disease Pipeline Report. […] The anticipated launch of these emerging celiac disease therapies is poised to significantly impact the market by offering new treatment options for a patient population that has been historically limited to a strict gluten-free diet. […] The future of the celiac disease treatment market is highly promising, driven by continuous advancements in medical research and an increasing understanding of the diseases underlying mechanisms. […] Innovations in enzyme therapies, immunotherapies, and drug development are creating new opportunities to manage and potentially cure the disease. […] As treatment options become more effective and accessible, celiac disease patients can look forward to a future where managing the condition is less restrictive, more efficient, and potentially curative.
  • #2 New Developments in Celiac Disease Treatment
    https://www.mdpi.com/1422-0067/24/2/945
    A GFD will only be effective if the patient complies. […] Drug discovery for treating CD, as a complement to a GFD, aims to intervene in different scenarios, including (a) maintenance therapy, (b) rescue therapy after acute gluten exposure, and (c) the mitigation of inadvertent chronic gluten exposure. […] Currently, the only proven effective treatment for CD is a lifelong GFD. […] Pharmacological treatments for CD may be more useful, at least in the short term, for patients unresponsive to a GFD and may also be useful as an adjunctive treatment in association with a GFD, especially considering the high rate of gluten contamination in the diet due to either inadvertent consumption or non-compliance. […] To mitigate gluten contamination in the diet, two drugs currently present the most advanced clinical research: larazotide and latiglutenase. […] Latiglutenase is a mix of glutenases that, in phase 2 studies, has been shown to prevent mucosal degradation and symptom development as a result of gluten contamination or challenge. […] Latiglutenase is a strong contender to become a standard adjunctive therapy in the treatment of CD.
  • #2 Future Therapies | Celiac Disease FoundationBack to HomeBack to HomeAbout the DiseaseGluten-Free ResourcesResearch ResourcesAdvocacy and Public PolicyJoin the EffortSupport the FoundationShare on FacebookShare on TwitterEmail this pageprinter-miniRelated
    https://celiac.org/about-celiac-disease/future-therapies-for-celiac-disease/
    Enteralia is developing E40, an oral enzyme that effectively breaks down gluten even in the absence of pepsin. […] IGY Life Sciences is researching the effectiveness of an oral therapeutic using a capsule-based format to deliver the antibodies directly to the small intestine where the inflammation takes place for better management of celiac disease. […] IM Therapeutics’ approach to celiac disease is to identify and develop an oral small-molecule drug that blocks the function of HLA-DQ2, the major genetic risk factor for celiac disease. […] Imcyse is applying its Imotope™ technology for the treatment of various chronic autoimmune diseases, including celiac disease. […] Parvus is developing a pipeline of novel Navacim™ candidates, which create disease-specific immune suppression while avoiding general immune suppression.
  • #2 New study demonstrates the efficacy of a promising celiac disease drug at the molecular level
    https://medicalxpress.com/news/2024-06-efficacy-celiac-disease-drug-molecular.html
    A new international study led by Tampere University analyzed molecular mechanisms to investigate whether ZED1227 is a potential drug candidate for treating celiac disease. […] „By measuring gene activity, we found that orally ingested ZED1227 effectively prevented gluten-induced intestinal mucosal damage and inflammation. In the drug group, the activity of the genes responsible for the absorption of nutrients and trace elements also returned to the pre-gluten exposure level,” Viiri says. […] „It is still premature to say that ZED1227 will be the celiac medicine of the future eliminating the need for a gluten-free diet. However, it is a strong drug candidate that could potentially be used in conjunction with a gluten-free diet.”
  • #2 Barinthus Bio Initiates Phase 1 Clinical Trial of VTP-1000
    https://www.globenewswire.com/news-release/2024/09/24/2952091/0/en/Barinthus-Bio-Initiates-Phase-1-Clinical-Trial-of-VTP-1000-for-the-Treatment-of-Celiac-Disease.html
    VTP-1000 is an investigational, injectable antigen-specific tolerance immunotherapy that utilizes Barinthus Bios proprietary SNAP-TI platform to co-deliver multiple gluten-derived peptide antigens (from wheat, barley and rye proteins) and the immunomodulator rapamycin in nanoparticles to promote immune tolerance to gluten.
  • #2 New coeliac disease treatments and their complications | Gastroenterología y Hepatología (English Edition)
    https://www.elsevier.es/en-revista-gastroenterologia-hepatologia-english-edition–382-articulo-new-coeliac-disease-treatments-their-S2444382418300415
    Different drugs or non-dietary therapeutic approaches are currently being developed that may be a medium- or long-term useful option in CD. […] Therapies that induce immune tolerance to gluten have the potential to allow gluten to be added to diets again. […] However, until further studies are available on the use of novel therapies in routine clinical practice, strict compliance with a GFD is still the basic treatment.
  • #2 Celiac Disease Psychosocial Services – Stanford Medicine Children’s Health
    https://www.stanfordchildrens.org/en/services/celiac-disease/psychosocial-services.html
    We can provide nonpharmacological (nonmedicine) techniques and behavioral therapies to help your child cope with pain and other bothersome symptoms. […] If your child is struggling with following the gluten-free diet, our psychologist, dietitian, and social worker collaborate with you and our medical providers to support adherence (staying on track with a treatment plan) by using creative and innovative strategies. […] Our celiac disease social worker partners with you to support your child’s academic growth and success.
  • #3 Clinical Practice Update: How to manage refractory celiac disease – American Gastroenterological AssociationAGA Logo_Horizontal
    https://gastro.org/news/clinical-practice-update-how-to-manage-refractory-celiac-disease/
    Perform small bowel imaging with capsule endoscopy and computed tomography or magnetic resonance enterography to exclude enteropathy-associated T-cell lymphoma and ulcerative jejunoileitis at initial diagnosis of type 2 refractory celiac disease. […] Complete a detailed nutritional assessment with investigation of micronutrient and macronutrient deficiencies in patients diagnosed with refractory celiac disease. Check albumin as an independent prognostic factor. […] Correct deficiencies in macro- and micronutrients using oral supplements and/or enteral support. Consider parenteral nutrition for patients with severe malnutrition due to malabsorption. […] Corticosteroids, most commonly open-capsule budesonide or, if unavailable, prednisone, are the medication of choice and should be used as first-line therapy in either type 1 or type 2 refractory celiac disease.
  • #3 Treatment for Refractory Celiac Disease
    https://www.verywellhealth.com/refractory-celiac-disease-treatment-562630
    Patients with Type II refractory disease often see some relief from their symptoms from this type of drug regimen, but unfortunately, their intestinal lining doesn’t heal from it, and it doesn’t seem to protect them against the deadly form of non-Hodgkin lymphoma linked with celiac disease. […] Nonetheless, some clinicians have begun to use Cladribine as their first choice for treating Type II refractory celiac disease, and find that they’re able to put about half of their patients into remission with the drug. […] Finally, for those with Type II refractory celiac disease who fail to respond to all other treatments, including Cladribine, at least one celiac center, the same one that published the Cladribine trial results, has tested autologous stem cell transplant, a procedure in which stem cells from your bone marrow are harvested, grown in the lab and then transplanted back into you following high-dose chemotherapy.
  • #3 New and Developing Therapies for Celiac Disease
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3002532/
    Nondietary therapies have focused on three main areas: to decrease gluten exposure, to modify intestinal permeability and to modulate immune activation. […] Enzyme therapy is attractive because physicians are familiar with using enzyme preparations to treat lactose intolerance and pancreatic insufficiency. […] Another therapeutic target is to prevent the migration of luminal gluten peptides across the intestinal epithelium. […] While therapies currently being investigated aim to decrease the amount of gluten reaching the small bowel or its migration across the intestinal epithelium, another potential target of drug therapy is modulation of the immune response to gluten. […] Therapies to decrease gluten exposure, to modify intestinal permeability and to modulate immune activation, represent exciting emerging treatments for celiac disease, but a gluten-free diet is virtually without side effects. […] The gluten-free diet still represents the best and safest treatment for celiac patients.
  • #3 Future Therapies | Celiac Disease FoundationBack to HomeBack to HomeAbout the DiseaseGluten-Free ResourcesResearch ResourcesAdvocacy and Public PolicyJoin the EffortSupport the FoundationShare on FacebookShare on TwitterEmail this pageprinter-miniRelated
    https://celiac.org/about-celiac-disease/future-therapies-for-celiac-disease/
    Provid focuses on synthetic and medicinal chemistry and is developing inhibitors of DQ2 and DQ8, the two genes associated with celiac disease. […] Barinthus Bio is developing VTP-1000 for the treatment of celiac disease. […] Chugai is developing an investigational medication designed to target an immune complex known to cause celiac disease symptoms. […] Forte initiated patient-based studies in celiac disease in the third quarter of 2024. […] Immunic is currently preparing for further clinical testing of IMU-856. […] Mozart Therapeutics is currently conducting a phase 1a/b clinical trial of MTX-101. […] The goal of this phase 1b study was to learn whether PTG-100 can reduce or prevent inflammatory injury to the small intestine that occurs when people with celiac disease eat food products containing gluten.
  • #3 Celiac Disease Treatment: Are We Close to a Cure? – The New York Times
    https://www.nytimes.com/2022/06/01/well/celiac-disease-treatment.html
    Vaccine-like therapies for celiac disease, which would teach the immune system to tolerate gluten, are also being investigated, Dr. Fasano said. He called this approach the “holy grail” because it could allow people to safely consume larger amounts of gluten. […] With so many different types of therapies in the pipeline, Dr. Verdú said she hopes to eventually have several medications, some of which may be used in combination, to offer to her celiac patients.
  • #4 Clinical Practice Update: How to manage refractory celiac disease – American Gastroenterological AssociationAGA Logo_Horizontal
    https://gastro.org/news/clinical-practice-update-how-to-manage-refractory-celiac-disease/
    Patients with refractory celiac disease require regular follow-up by a multidisciplinary team, including gastroenterologists and dietitians, to assess clinical and histologic response to therapy. Identify local experts with expertise in celiac disease to assist with management. […] Patients with refractory celiac disease without response to steroids may benefit from referral to a center with expertise for management or evaluation for inclusion in clinical trials.
  • #4 Future Therapies | Celiac Disease FoundationBack to HomeBack to HomeAbout the DiseaseGluten-Free ResourcesResearch ResourcesAdvocacy and Public PolicyJoin the EffortSupport the FoundationShare on FacebookShare on TwitterEmail this pageprinter-miniRelated
    https://celiac.org/about-celiac-disease/future-therapies-for-celiac-disease/
    KAN-101 acts by re-educating T cells, or tolerizing them, so they do not respond to gluten antigens. […] Entero is developing latiglutenase (also known as IMGX003), a mixture of two gluten-specific enzymes that break down gluten proteins into small, harmless fragments. […] Investigators at Oslo University Hospital are currently testing the effects of teriflunomide on patients with celiac disease. […] Investigators at the Massachusetts General Hospital are conducting a double-blind, placebo-controlled trial to establish the safety and efficacy of Ritlecitinib to prevent gluten-induced symptoms in celiac disease patients. […] A phase 2b clinical trial was completed in 2024. […] Investigators are conducting a Phase 2a/b study to evaluate the efficacy and safety of Amlitelimab in adult participants with non-responsive celiac disease who are on a gluten-free diet.
  • #5 Future Therapies | Celiac Disease FoundationBack to HomeBack to HomeAbout the DiseaseGluten-Free ResourcesResearch ResourcesAdvocacy and Public PolicyJoin the EffortSupport the FoundationShare on FacebookShare on TwitterEmail this pageprinter-miniRelated
    https://celiac.org/about-celiac-disease/future-therapies-for-celiac-disease/
    Takeda is currently conducting a phase 2 dose-ranging study to evaluate the efficacy and safety of TAK-062 for the treatment of active celiac disease in individuals attempting a gluten-free diet. […] Takeda is conducting a phase 2 dose-ranging study to further explore the potential of TAK-101 in the treatment of patients with celiac disease on a gluten-free diet. […] A phase 2a proof-of-concept gluten-challenge study revealed that TAK-227 successfully reduced gluten-induced duodenal mucosal damage in people with celiac disease. […] Teva is now conducting a phase 2a trial assessing whether the study drug reduces intestinal damage and inflammation attributed to celiac disease after gluten consumption.

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