An experimental drug has been proven to relieve symptoms for some people with celiac who recover poorly despite following the gluten-free diet. Latiglutenase is an enzyme supplement that helps digest gluten. Previous research showed it might protect patients from low levels of gluten eaten accidentally. While clinical studies have not proven it prevents damage to the small intestine, it did relieve the participants’ most common complaints of abdominal pain, bloating, fatigue and constipation.
Latiglutenase, formerly known as ALV003, has been in development since 2016 by drug company ImmunogenX, based in Newport Beach, California. Experts at the Mayo Clinic, Columbia University and Stanford University assisted this study. It included 398 people diagnosed with celiac who had avoided gluten for a year but still had painful symptoms. Blood tests showed 173 (43 percent) continued to produce antibodies associated with inflammation. Researchers randomly assigned them to take a placebo or different doses of latiglutenase for 12 weeks.
This trial originally tried and failed to find evidence the drug promoted intestinal healing. However, further analysis found a significant improvement in symptoms for those patients with elevated antibodies receiving latiglutenase versus a placebo. The effect increased with dosage and most greatly benefitted patients with the most severe pain.
What does it mean?
The authors recommend similar patients would benefit from having latiglutenase commercially available. It would not cure celiac or allow patients to eat foods containing gluten. However, it would make life easier for a significant proportion of patients who remain ill despite a gluten-free diet. It would be taken with meals, yielding a similar effect to that of lactase for people with lactose intolerance.
All researchers on this study declared professional or financial ties with ImmunogenX and other drug companies.
Syage JA, Murray JA, Green PHR, Khosla C, “Latiglutenase improves symptoms in seropositive celiac disease patients while on a gluten-free diet,” Digestive Diseases and Sciences 2017;62:2428-2432, doi:10.1007/s10620-017-4687-7.
