TNF Alpha Inhibitors vs. Biologic Therapies

If you have Crohn’s disease, you may go through a variety of treatments before you find one that effectively manages your symptoms.

The first line of treatment for Crohn’s disease is often immunotherapy. This involves drugs that modify the way your immune system reacts to what’s perceived as a threat.

TNF-alpha inhibitors are known as biologic therapies, and they aren’t the only type available. TNF stands for “tumor necrosis factor.” Another aggressive therapy, called natalizumab, is also available. TNF-alpha inhibitors and natalizumab can both have very serious side effects. They’re usually only prescribed if other treatments haven’t worked.

What Is Biologic Therapy?

Biologic therapy refers to any therapy that works to block the immune system’s natural response to antigens, or something your body perceives as harmful. In people with Crohn’s disease, the body’s immune system can’t tell the difference between foreign substances and the body’s own tissue. This causes the inflammation that creates so many symptoms.

Biologic therapies, unlike other treatments for Crohn’s disease, aggressively target particular proteins that cause inflammation of the gastrointestinal tract. This often makes them successful when no other treatment has worked. However, this aggressive therapy can compromise your health in other ways.

TNF-Alpha Inhibitors

TNF-alpha inhibitors are sold under the brand names Remicade, Humira, and Cimzia.

Some people with Crohn’s disease are able to take a TNF-alpha inhibitor at home. These people are given prefilled pens or syringes with just the right amount of medicine. They’re given a dosage schedule and allowed to administer treatment themselves.

Costs and Risks of TNF-Alpha Inhibitors

TNF-alpha inhibitors block the immune response that causes Crohn’s disease symptoms to happen. However, blocking this immune response can create new problems. These drugs can’t solely block your immune system from attacking your own tissue while leaving your natural immune responses intact. This leaves you susceptible to other diseases and infections and can sometimes increase the risk of developing certain cancers.

You can have an increased risk of tuberculosis while on this medication. In addition to injections or intravenous treatments, you’ll also need regular skin tests to make sure you aren’t infected.

TNF-alpha inhibitors are expensive. Treatments can cost up to thousands of dollars. Some medications require people to spend hours in the doctor’s office receiving treatment intravenously. This can also time-consuming and costly if you need to take a lot of time off from work for treatment.

Natalizumab

Natalizumab (Tysabri) works by interfering with the process of white blood cells attaching to the lining of the intestines. This reduces inflammation and relieves other symptoms. Some severe, even fatal, side effects have been associated with natalizumab. Its benefits in treating Crohn’s disease should be weighed against the side effects and benefits of TNF-alpha inhibitors when making treatment decisions.

This drug is often prescribed for people with multiple sclerosis, but it was approved for the treatment of Crohn’s disease in 2008.

Before being able to take natalizumab, you must be enrolled in a program called CD Touch. This stands for “Crohn’s Disease Tysabri Outreach Unified Commitment to Health”. This requirement is due to the extreme risk of a rare but deadly brain disorder that has been connected with natalizumab. The disorder is called progressive multifocal leukoencephalopathy. It’s an inflammation of the white matter of the brain, and it usually occurs in more than one location.

Your doctor will most likely wait to prescribe biologic treatments until you’ve tried all other therapies and they haven’t been successful. Make sure you understand the possible side effects of all medications your doctor prescribes for you.