A potential cure for celiac disease! promising results in a Phase 2 RCT.

Celiac disease is an autoimmune disease affecting the intestine, tissue transglutaminase antibodies were found to be elevated in these patients and are also important prognostically and for disease monitoring. Gluten free diet was widely prescribed as part of treatment. However, a phase 2 RCT was published on NEJM today in which an inhibitor to enzyme transglutaminase 2 which breaks down amide group from glutamine in gluten, enhancing T-cell response was assessed for its efficacy and safety.

Image-1, transglutaminase 2 action on T cells.

159 individuals with confirmed celiac disease controlled with diet were assigned to 3 different doses of drug ZED1227, a selective oral transglutaminase inhibitor, efficacy and safety was assessed in these individuals. the primary end point is attenuation of gluten induced mucosal damage.

The results were promising with significant reduction in mucosal injury (ratio of villous height to crypto depth) in intervention group across all the three doses compared to placebo.

How ever this is preliminary study, larger study need to done to assess the efficacy and safety.

link to original article.

Ref- A Randomized Trial of a Transglutaminase 2 Inhibitor for Celiac Disease | NEJM. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa2032441?query=featured_home

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