Growth hormone is involved in the control ofintestinal permeability (Nayer and Rhodes 2004). Preliminary studies of growth hormone (somatropin) in adult patients with CD suggest that it may be beneficial (Slo-nim et al. 2000). Growth hormone is also being evaluated in phase 2 studies in children with CD (who frequently experience growth failure as a complication of CD) (Calenda et al. 2005).
Sargramostim, granulocyte-macrophage colony-stimulating factor, a hematopoietic growth factor, stimulates cells of the intestinal innate immune system. Preliminary studies suggest that sargramostim may have activity in CD (Dieckgraefe and Korzenik 2002). In 124 patients with moderate to severe CD, sargramo-stim did not statistically differentiate from placebo for the primary endpoint, a clinical response (CDAI decrease > 70) at the end of treatment (Day 57); however, more sargramostim-treated patients achieved clinical response 100 (100-point decrease from baseline in CDAI) and remission (CDAI < 150) than placebo-treated patients at the end of the study. Additionally, patients receiving sargramostim experienced significant improvements in quality of life (Korzenik et al. 2005). This agent is currently in phase 3 trials for CD in adults and in phase 2 trials for pediatric CD.
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