Chemotherapy for Crohn’s Disease
Learn how certain chemotherapy drugs, including 6-MP, Remicade, and Methotrexate, can benefit people with Crohn's disease.
Chemotherapy involves treating an illness using chemicals and has long been among the most successful treatments for patients with various forms of cancer. Certain forms of chemotherapy also have been effective for autoimmune disorders like Crohn’s disease.
6-MP
Administered orally, usually in tablet form, mercaptopurine, also known as 6-MP, is among the more popular chemotherapy treatments used for Crohn’s sufferers. 6-MP has been classified as an antimetabolite, a drug that interferes with metabolic action. Although antimetabolites have been found to be effective in the treatment of Crohn’s, they’ve been associated with side effects, too.
As with traditional forms of chemotherapy, the side effects of 6-MP can be difficult to handle. Extreme side effects include a temporary reduction in white and red blood cell count, which can increase your risk of infection and anemia. Liver problems and traditional chemotherapy side effects like nausea and vomiting may occur.
Methotrexate
Methotrexate is another popular Crohn’s prescription that has roots in chemotherapy treatments. Originally used for breast cancer patients, methotrexate is also used as chemotherapy for lymphoma and leukemia, among other illnesses. For treatment of autoimmune disorders, the dosage is lowered to a safer level.
Administered once a week, either orally or via injection, methotrexate blocks cell production, making it effective in controlling the inflammation caused by Crohn’s disease. Methotrexate’s side effects include a reduction in blood cells produced by bone marrow, which can lead to complications. Methotrexate patients may be required to be tested occasionally to ensure adequate blood count. Patients taking methotrexate will often receive blood tests every two months to test liver function and creatinine levels in the urine to test for kidney function. Lung scarring is possible, so patients may be asked to watch for issues such as persistent coughing or trouble breathing.
Remicade (infliximab) (, a TNF blocker) often used in treating Crohn’s disease, has been reclassified as a chemotherapy drug because it requires special safety standards by the facilities that use it. It also falls into this category because it works by blocking proteins created by blood cells in your body.
Remicade is administered via IV, in a medical facility during an appointment that can take hours. Remicade is often used in more severe Crohn’s patients because it carries a lymphoma cancer risk, mostly among younger patients who take it. It also carries a risk of tuberculosis, which has sometimes been fatal among Crohn’s sufferers taking the drug.
Some people have experienced allergic reactions to Remicade, and a few have reported lupus-like symptoms, including chest or joint pains, shortness of breath, and rashes. If you begin to experience these side effects, your doctor may choose to either change your dosage or take you off the drug altogether.
Cyclosporine
Cyclosporine, also used in chemotherapy, has shown to be effective for Crohn’s sufferers. Like other medications used in the treatment of Crohn’s, cyclosporine decreases the body’s immune response.
Cyclosporine is traditionally used to prevent rejection during organ or bone marrow transplants. Although it’s still unproven in the treatment of Crohn’s, the theory in using it is that weakening the body’s immune response will result in a lessening of inflammation in the gastrointestinal tract.
Some Crohn’s patients suffer from fistulas, abnormal connections in the intestines that can create discharge, fever, pain, and itching. Cyclosporine has had success in closing the resulting openings. Some of the more severe side effects of cyclosporine include blood in the urine, high blood pressure, and kidney and liver problems. Because cyclosporine has such severe side effects, it’s rarely used to treat Crohn’s.
In 1997, researchers conducted a trial to determine if antituberculous chemotherapy worked in patients suffering from Crohn’s. The basis for this test was the theory that mycobacterium paratuberculosis is the cause of Crohn’s—a theory that has not been proven.
Mycobacterium paratuberculosis is a bacterial infection originates from the milk, feces, and meat of infected cattle. Some believe that the bacteria isn’t killed off during the cooking process and infects the humans who eat it, leading to Crohn’s.
Researchers hoped to eradicate Crohn’s disease in test subjects by using antituberculous chemotherapy, a tuberculosis treatment. However, the two-week trial found no change in Crohn’s patients participating in the study. At the end of the study, researchers concluded no detectable link between mycobacterium paratuberculosis and Crohn’s disease.
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