Condition

Celiac Disease

Autoimmune disorder triggered by gluten

56.7M
People Affected
40
Active Trials
1.1M
New Cases/Year
500
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Gluten-Free Diet (GFD)
95% Effectiveness• 95% Confidence• 95% Safety• 21 trials0
HIGH EvidenceExcellent ValueDose: Strict avoidance of all gluten-containing foods
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
95
DangerousModerateSafe

Time to Effect

Weeks to months for symptom resolution and mucosal healing

Duration

Lifetime

Response Rate

85%

Remission Rate

70%

Common Side Effects:

Nutritional deficiencies (e.g., iron, vitamin D, folate): 30%
Social and psychological burden: 50%
Increased cost of gluten-free foods: 100%
Accidental gluten exposure leading to symptoms: 40%

Annual Cost of Care

Drug Cost

$0

Monitoring

$700

Side Effects

$200

Total Annual

$2,400

Cost-Effectiveness

EXCELLENT

QALYs Gained

2.5

Cost per Remission

$3,428

Cost per Responder

$2,823

Treatment Outcomes
Primary Outcomes
tTG-IgA Antibody Levels200 U/mL (significantly elevated, >10x ULN)
-90% (-180 U/mL (to 20 U/mL, within normal limits))
Intestinal Villous Height to Crypt Depth (Vh:Cd) Ratio0.5:1 (severe villous atrophy)
+300% (+1.5:1 (e.g., from 0.5:1 to 2.0:1, representing significant healing))
Celiac Disease Gastrointestinal Symptom Score (0-100, higher is worse)60/100
-70% (-42 points (from 60 to 18))
Secondary Benefits
Celiac Disease Quality of Life (CD-QOL) Score (0-100, higher is better)40/100
+50% (+20 points (from 40 to 60))
Fatigue Severity Scale (FSS) Score (1-7, higher is worse)5.5/7
-40% (-2.2 points (from 5.5 to 3.3))
Serum Ferritin15 ng/mL (iron deficiency)
+100% (+15 ng/mL (from 15 to 30 ng/mL))
Common Side Effects
Nutritional deficiencies (e.g., iron, vitamin D, folate)
+30%
Social and psychological burden
+50%
Increased cost of gluten-free foods
+100%
2
Nutritional Supplementation (e.g., Iron, Vitamin D, Folate, B12)
80% Effectiveness• 90% Confidence• 85% Safety• 50 trials• 10K participants
HIGH EvidenceExcellent ValueDose: Varies by deficiency and specific supplement
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
85
DangerousModerateSafe

Time to Effect

Weeks to months to correct deficiencies

Duration

Ongoing as needed

Response Rate

90%

Remission Rate

90%

Common Side Effects:

Gastrointestinal upset (iron): 10%
Hypercalcemia (high dose vitamin D): 1%

Annual Cost of Care

Drug Cost

$100

Monitoring

$150

Side Effects

$0

Total Annual

$250

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.5

Cost per Remission

$277

Cost per Responder

$277

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+80%
Response Rate
+90%
Remission Rate
+90%
Common Side Effects
Gastrointestinal upset (iron)
+10%
Hypercalcemia (high dose vitamin D)
+1%
3
Larazotide Acetate (Investigational)
60% Effectiveness• 65% Confidence• 80% Safety• 10 trials• 2K participants
MODERATE EvidenceDose: 0.5 mg three times daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

Weeks

Duration

Long-term daily

Response Rate

40%

Remission Rate

%

Number Needed to Treat (NNT)

7

Common Side Effects:

Headache: 15%
Abdominal pain: 10%
Nausea: 8%
Diarrhea: 7%

Annual Cost of Care

Drug Cost

$5,000

Monitoring

$100

Side Effects

$50

Total Annual

$5,150

QALYs Gained

0.2

Cost per Responder

$12,875

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+60%
Response Rate
+40%
Common Side Effects
Headache
+15%
Abdominal pain
+10%
Nausea
+8%

Clinical Trial Phases:

Phase 3
4
Latiglutenase (ALV003 / BL-7010) (Investigational)
55% Effectiveness• 60% Confidence• 80% Safety• 8 trials• 1.5K participants
MODERATE EvidenceDose: 300 mg before meals
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

With meals

Duration

Long-term, with meals

Response Rate

35%

Remission Rate

%

Number Needed to Treat (NNT)

9

Common Side Effects:

Abdominal pain: 12%
Flatulence: 10%
Nausea: 5%

Annual Cost of Care

Drug Cost

$4,500

Monitoring

$100

Side Effects

$50

Total Annual

$4,650

QALYs Gained

0.15

Cost per Responder

$13,285

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+55%
Response Rate
+35%
Common Side Effects
Abdominal pain
+12%
Flatulence
+10%
Nausea
+5%

Clinical Trial Phases:

Phase 2Phase 3
5
ZED1227 (Investigational)
50% Effectiveness• 60% Confidence• 78% Safety• 5 trials• 700 participants
MODERATE EvidenceDose: 10-100 mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
78
DangerousModerateSafe

Time to Effect

Weeks

Duration

Long-term daily

Response Rate

30%

Remission Rate

%

Common Side Effects:

Headache: 10%
Diarrhea: 8%
Abdominal discomfort: 6%

Annual Cost of Care

Drug Cost

$6,000

Monitoring

$100

Side Effects

$50

Total Annual

$6,150

QALYs Gained

0.1

Cost per Responder

$20,500

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+50%
Response Rate
+30%
Common Side Effects
Headache
+10%
Diarrhea
+8%
Abdominal discomfort
+6%

Clinical Trial Phases:

Phase 2