While remission is the primary goal for patients with Crohn’s disease, biologic therapies may provide a way for sufferers to achieve a level of comfort. Biologic therapies work by blocking TNF (tumor necrosis factor)—a condition where high amounts of protein are produced by the body’s immune system—to prevent inflammation in the intestines.
However, biologic therapies do present serious side effects. The process of biologic therapy reduces the body’s ability to fight infections, which can cause tuberculosis and other infections. There is also an increased chance of certain types of cancer in patients taking TNF blockers, which is especially prevalent in younger patients. One such cancer that could result is called Hepatosplenic T-cell Lymphoma, and is often fatal.
Biologic therapies are usually prescribed in patients with more severe Crohn’s symptoms who have not been able to achieve relief from symptoms using other methods.
Biologic therapies for Crohn’s patients may be a great treatment option. However, patients should weigh the risks of TNF blockers against the benefits, and generally biologic therapies are only used after less invasive treatments have been attempted.
Biologic therapies for Crohn’s Disease come in several brand names, each with varied dosage. Those therapies include:
Remicade doesn’t have to be taken every day in treating Crohn’s disease. In fact, after three starter doses, a patient can often see benefits in as few as six doses per year. The downfall is that Remicade must be given intravenously in a medical facility over a two-hour period.
Remicade is administered directly into the bloodstream, allowing it to begin work immediately to eradicate symptoms. Because it is administered in a medical facility, experienced healthcare professionals are close by at all times to monitor for side effects while the treatment is being administered and for a period of time afterwards.
Remicade may help patients gain control of flare-ups and maintain remission to help prevent symptoms from returning.
Humira is a self-administered treatment following an initial demonstration by a healthcare professional. If your doctor determines you can handle the injections yourself, you will be given a set of pens with dosage-controlled medicine inside. You will also be given instructions on how many injections to take for the first thirty days. After the initial thirty-day period, patients typically use one Humira pen every two weeks.
Cimzia is the only biologic treatment for Crohn’s Disease that utilizes certolizumab pegol, an antibody that fights TNF.
After several clinical trials, Cimzia was approved by the FDA in 2008 for Crohn’s treatment. The trials showed Cimzia was effective in battling many of the symptoms of Crohn’s, including diarrhea and stomach pain, and restoring a sense of general well-being in study participants within several weeks. Additionally, studies showed a sustained improvement in Crohn’s patients a few years later without patients having to increase their dosage.
Cimzia is administered via a small injection, which can either be given in a doctor’s office or at home. If you choose to receive treatment in a doctor’s office, you will be given the option of having your treatment in powder form, which is then mixed with sterile water and injected. The other option, which can be done at home or in a doctor’s office, is to use pre-filled syringes with the medicine already mixed in measured doses. If you choose to do the treatments yourself, you’ll be given a package with two syringes and instructions on administering the treatment. After the initial three doses, you will be able to take Cimzia every four weeks.
Crohn’s patients considering Tysabri should be aware of a very serious side effect. The FDA approved the drug in 2008 with an added warning about the risk of a rare brain disease called progressive multifocal leukoencephalopathy (PML). Any physician who prescribes Tysabri for Crohn’s Disease will warn patients of those risks, as well as enrolling them in an outreach program called CD Touch (Crohn’s Disease Tysabri Outreach Unified Commitment to Health).
In the early trials, three cases of PML were reported, which resulted in the drug being temporarily taken off the market before being reintroduced with the CD Touch program added as a requirement. But as of early 2011, 95 cases and 20 deaths had been added to those early numbers, according to Reuters.
Tysabri is not a TNF inhibitor and will usually not be prescribed until all other forms of treatment have been exhausted. Tysabri binds together certain white blood cells to prevent them from causing inflammation.
Tysabri is given intravenously every four weeks in a process that takes approximately one hour. Patients are usually observed for an hour afterward.