Understanding Crohn Disease Medications (cont.)
Francisco Talavera, PharmD, PhD
This class of drugs includes infliximab (Remicade), adalimumab (Humira),
- How biologic drugs work: These agents inhibit key factors responsible for inflammatory responses in the immune system
called TNF (tumor necrosis factor) blockers and are used for moderate-to-severe Crohn's disease.
- Who should not use these medications: Individuals who have allergy to a specific biologic agent should not use it. Those with allergy to mouse protein should not use biologic agents. People with moderate-to-severe heart failure should not
take doses greater than 5 mg/kg.
- Use: Infliximab is administered as a 2-hour intravenous infusion in doctors' offices. Initially, patients receive 3 doses within
a 6-week period; thereafter, they receive a dose every 8 weeks to maintain the effect.
Humira is a twice monthly subcutaneous injection that is usually
self-administered. Cimzia is a once a month intramuscular injection.
- Drug or food interactions: Use of other immunosuppressants increases the risk of infection.
- Side effects: These drugs may increase the risk of infection, particularly when other immunosuppressants are used at the same time.
There is a risk of reactivation of latent tuberculosis (TB) and hepatitis B. Individuals with
heart failure may experience worsening of heart disease. Biologic agents may cause fever, rash, headache, or muscle aches 3
to 12 days after administration. Over a period of time, patients' bodies may produce antibodies against infliximab, thereby
decreasing the drug's effectiveness. Humira and Cimzia are derived from
human antibodies to anti-TNF and hence, may be used in Remicade failures.
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