Review article: coeliac disease, new approaches to therapy.
BACKGROUND
Coeliac disease is managed by life-long gluten withdrawal from the diet. However, strict adherence to a gluten-free diet is difficult and is not always effective. Novel therapeutic approaches are needed to supplement or even replace the dietary treatment.


OBJECTIVE
To review recent advances in new therapeutic options for coeliac disease.


METHODS
A literature search was performed on MEDLINE, EMBASE, Web of Science, Scopus, DDW.org and ClinicalTrials.gov for English articles and abstracts. The search terms used included, but not limited to, 'Celiac disease', 'new', 'novel', 'Advances', 'alternatives' and 'Drug therapy'. The cited articles were selected based on the relevancy to the review objective.


RESULTS
Several new therapeutic approaches for coeliac disease are currently under development by targeting its underlying pathogenesis. Alternative therapies range from reproduction of harmless wheat strains to immunomodulatory approaches. Some of these therapies such as enzymatic cleavage of gluten and permeability inhibitors have shown promise in clinical studies.


CONCLUSIONS
Gluten-free diet is still the only practical treatment for patients with coeliac disease. Novel strategies provide promise of alternative adjunctive approaches to diet restriction alone for patients with this disorder.
Celiac Disease Research Program, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
S
S
Rashtak
J A
JA
Murray
D002446:Celiac Disease / Q000178:diet therapy*; D055050:Diet, Gluten-Free / Q000379:methods* / Q000592:standards; D015195:Drug Design; D005983:Glutens / Q000009:adverse effects* / Q000737:chemistry; D006801:Humans; D010349:Patient Compliance; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D014908:Triticum / Q000009:adverse effects* / Q000737:chemistry
D005983:Glutens