How Future Pharmacologic Therapies for Celiac Disease Will Complement the Gluten-Free Diet
Gastroenterology, vol. 167, pp. 90–103
Abstract
The only proven treatment for celiac disease is adherence to a strict, lifelong, gluten-free diet. However, complete dietary gluten avoidance is challenging and a substantial number of patients do not respond fully, clinically, or histologically, despite their best efforts. As celiac disease is common and its central pathophysiology is well elucidated, it has become attractive for drug development to address the limitations of dietary treatment. Most efforts address nonresponsive celiac disease, defined as continued symptoms and/or signs of disease activity despite a gluten-free diet, and the more severe forms of refractory celiac disease, types I and II. An increasing spectrum of therapeutic approaches target defined mechanisms in celiac disease pathogenesis and some have advanced to current phase 2 and 3 clinical studies. We discuss these approaches in terms of potential efficiency, practicability, safety, and need, as defined by patients, regulatory authorities, health care providers, and payors.
Authors 4
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Valentina Discepolo corresponding
University of Naples Federico II
Affiliation as printed
Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Diseases, University of Naples Federico II, Naples, Italy. Electronic address: valentina.discepolo@unina.it
Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Diseases (ELFID), University of Naples Federico II, Napoles, Italy
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Beth Israel Deaconess Medical Center · Harvard University
Affiliation as printed
Celiac Center, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
Celiac Center, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston Massachusetts
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Leiden University Medical Center
Affiliation as printed
Department of Immunology, Leiden University Medical Center, Leiden, The Netherlands
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Detlef Schuppan corresponding
Beth Israel Deaconess Medical Center · Harvard University · Johannes Gutenberg University Mainz
Affiliation as printed
Celiac Center, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts; Institute of Translational Immunology and Research Center for Immunotherapy, Center for Celiac Disease and Autoimmunity, Johannes-Gutenberg University, Mainz, Germany. Electronic address: detlef.schuppan@unimedizin-mainz.de
Celiac Center, Beth Israel Deaconess Medical Center & Harvard Medical School, Boston Massachusetts
Institute of Translational Immunology and Research Center for Immuner Therapy, Center for Celiac Disease and Autoimmunity, Johannes-Gutenberg University, Mainz, Germany
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