Biologics for Inflammatory Bowel Disease
How It Works
These medicines stop a protein that increases inflammation in the body. They block the inflammatory response that happens in Crohn's disease and ulcerative colitis. They are given as a shot. Infliximab and natalizumab are given as a shot in a vein (intravenous, or IV). Adalimumab and certolizumab are given as a shot under the skin (subcutaneous).
Why It Is Used
Infliximab was first used to treat abnormal connections (fistulas) between the intestines and organs in moderate to severe Crohn's disease. Now it is used to induce and maintain remission (a period without symptoms) in people who have Crohn's disease or ulcerative colitis that has not improved with other medicines.
Adalimumab, certolizumab, and natalizumab are used to induce and maintain remission in people with Crohn's disease who have not improved with other medicines and who no longer respond to or cannot tolerate treatment with infliximab.
How Well It Works
In multiple studies, almost 70% of people taking infliximab had fewer symptoms or had healed fistulas.1
Adalimumab has shown promise in treating Crohn's disease in multiple studies.2 It works like infliximab and may be good for people who are allergic to infliximab.
Studies show that natalizumab works to stop the symptoms Crohn's disease in some people and to keep some people free of symptoms. But natalizumab may cause a serious and life-threatening disease called PML. Because of this risk, natalizumab is only available through a special prescription drug program.5
In one study, between 60% and 70% of people with ulcerative colitis were better 8 weeks after getting infliximab treatment. In another study, twice as many people got better after receiving infliximab compared to those taking a placebo.6
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Call your doctor right away if you have:
Common side effects of this medicine include:
What To Think About
Warnings about serious side effects of biologics have been issued. The U.S. Food and Drug Administration (FDA) and the drug's manufacturers have warned about:
In very few cases, natalizumab has caused a serious and life-threatening disease called PML. Natalizumab is tightly controlled because of this. If you take natalizumab, you will need to enroll in a program called the Crohn's Disease–Tysabri Outreach Unified Commitment to Health (CD-TOUCH) Prescribing Program.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
eMedicineHealth Medical Reference from Healthwise
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