If you have Crohn’s disease, you may try a variety of treatments before you find one that effectively manages your symptoms. Biologics are a treatment option that many people find effective.
Treatment for Crohn’s disease often targets the immune system. This involves drugs that modify the way your immune system reacts to what’s perceived as a threat. By doing so, these medications can reduce inflammation and symptoms of Crohn’s.
Biologic therapies are different from conventional medications because they come from molecules found in life, as opposed to chemicals. They offer a targeted approach, which means they affect a specific part of the body rather than the whole body.
Biologics are powerful therapies for Crohn’s disease. Doctors usually prescribe them for moderate to severe Crohn’s symptoms or if other treatments haven’t worked.
- improve symptoms
- reduce inflammation
- reduce the risk of a flare
- improve your quality of life
Biologics are medications made from living cells that work to block the immune system’s natural response to antigens, or something your body perceives as harmful.
In people with Crohn’s disease, the 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 (GI) tract. This often makes them successful when no other treatment has worked.
However, biologics can have severe side effects that can compromise your health in other ways. Before using a biologic for Crohn’s disease, talk with a healthcare professional about the side effects.
There are three types of biologics:
- TNF-alpha inhibitors
- integrin blockers
- interleukin blockers
TNF-alpha inhibitors include:
Some people with Crohn’s disease can take a TNF-alpha inhibitor at home. A doctor will give you prefilled pens or syringes with just the right amount of medication. They will also give you a dosage schedule, and you then administer treatment yourself.
TNF-alpha inhibitors block the immune response that causes Crohn’s disease symptoms. However, blocking this immune response can create new problems. It can leave you susceptible to other diseases and infections, and can sometimes increase the risk of developing certain cancers.
You may have an increased risk of tuberculosis while using this medication. In addition to injections or intravenous treatments, you’ll also need regular skin tests to check for infections.
TNF-alpha inhibitors are expensive. Treatments can cost up to thousands of dollars.
Some of these medications require people to spend hours in the doctor’s office receiving treatment intravenously. This can also be time consuming and costly if you need to take a lot of time off from work for treatment.
Natalizumab (Tysabri) and vedolizumab (Entyvio) are integrin blockers. These medications work 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 integrin blockers. Their benefits in treating Crohn’s disease should be weighed against the side effects and benefits of TNF-alpha inhibitors when making treatment decisions.
Before being able to take natalizumab, you must be enrolled in a program called TOUCH. The TOUCH prescribing program is the only way you can receive Tysabri.
The prescribing program requirement is due to the risk of a rare but deadly brain disorder that has been connected with natalizumab.
The disorder is called progressive multifocal leukoencephalopathy (PML). It’s an inflammation of the white matter of the brain.
Vedolizumab doesn’t appear to have the same risk of PML that natalizumab does, even though both drugs work in similar ways.
The third class of biologics used to treat Crohn’s is interleukin inhibitors. Ustekinumab (Stelara) is the only drug in this class that’s been Food and Drug Administration approved.
Ustekinumab targets two specific proteins that are thought to cause inflammation: interleukin-12 (IL-12) and interleukin-23 (IL-23). People with Crohn’s have higher levels of IL-12 and IL-23 in their body.
By targeting these proteins, ustekinumab blocks inflammation in the GI tract and decreases symptoms of Crohn’s disease.
Ustekinumab is used to treat adults with moderate to severe Crohn’s that hasn’t responded well enough to conventional therapy. It’s initially given intravenously under the supervision of a healthcare professional.
Following doses of ustekinumab can be given via an injection under the skin every 8 weeks, by either a healthcare professionals or patients themselves after they’ve received training.
Like other biologics, ustekinumab can increase the risk of infections.
A doctor may prescribe biologic therapies if you have moderate to severe Crohn’s disease or if other treatments haven’t worked for you.
Make sure to ask about and fully understand the possible side effects of all medications your doctor prescribes for you.