title: Emerging drugs for celiac disease.
abstract: BACKGROUND
  Celiac disease is an immune-mediated gluten-dependent disorder, primarily affecting the small intestine in genetically predisposed individuals. The disorder has a very heterogeneous clinical and histopathological spectrum. Current treatment with a gluten-free diet is very effective, but the diet is difficult to maintain and remains costly.
  
  
  METHODS
  Alternatives to the gluten-free diet have been proposed to either replace this current treatment, or at least, to supplement use of the gluten-free diet. Studies in the published English language literature relevant to this review were examined for this report.
  
  
  CONCLUSIONS
  Most recent published double-blind, placebo-controlled clinical trials have focused on an orally administered recombinant glutenase (ALV003) showing significant but limited benefit to celiac disease patients already compliant with a gluten-free diet. Other studies have addressed other immune mechanisms that may play a role in its pathogenesis and have not been so positive. Added investigations, particularly over the long-term, in other larger and more heterogeneous populations are needed.
authors.affiliation: University of British Columbia, Department of Medicine (Gastroenterology) , Vancouver, BC , Canada hugfree@shaw.ca.
authors.forename: Hugh James
authors.initials: HJ
authors.lastname: Freeman
mesh_terms: D000284:Administration, Oral; D002446:Celiac Disease / Q000178:diet therapy / Q000188:drug therapy* / Q000503:physiopathology; D055050:Diet, Gluten-Free; D015195:Drug Design; D005983:Glutens / Q000009:adverse effects; D006801:Humans; D010349:Patient Compliance; D010447:Peptide Hydrolases / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D005983:Glutens; C571240:ALV003; D010447:Peptide Hydrolases
keywords: celiac disease; celiac disease therapy; enzyme treatment; gluten-free diet; gluten-sensitive enteropathy; glutenase; larazotide