A Randomized Trial of a Transglutaminase 2 Inhibitor for Celiac Disease
In a proof-of-concept trial (n=163 who underwent a daily gluten challenge), 6-weeks treatment with ZED1227 at all 3 dose levels attenuated gluten-induced duodenal mucosal injury and 100-mg dose may have improved symptom and quality-of-life scores vs. placebo.
Source:
New England Journal of Medicine
SPS commentary:
According to an editorial, the need for the development of an adjunct treatment to the gluten-free diet is supported by the difficulties in strictly excluding gluten from the diet and by the lack of mucosal healing that has been observed in 40% of adults with coeliac disease who maintain a gluten-free diet. It notes ZED1227 is the first non-dietary treatment that has preliminarily shown the capacity to prevent mucosal damage in persons with celiac disease. It adds that although this trial is very encouraging, whether treatment with ZED1227, and more generally transglutaminase 2 inhibition, in patients with coeliac disease will be effective in real life and during long-term gluten exposure remains to be determined.