Crohn’s disease is an inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract. Most often it affects the end of the small intestine (ileum), the colon, or both.
It’s not curable, but you can work toward disease remission with effective treatment. This can help improve your quality of life.
If your Crohn’s treatment is not working as well as you’d hoped, your doctor may recommend trying biologics.
These are drugs made from living cells that target the body’s inflammation response. They are most often used for moderate to severe Crohn’s that isn’t responding well to conventional therapies.
Like most medications, biologics have both benefits and risks. They can reduce your inflammation, and in doing so, stall the progression of your Crohn’s. However, they can also put you at risk for infections and certain cancers.
Some doctors recommend avoiding the risks associated with biologics by saving that treatment for when other therapies aren’t working. Other doctors advocate for a top-down approach. This is when you try biologics sooner rather than later to stop intestinal damage before it starts.
Your healthcare team can help you weigh the risks and benefits so you can make an informed decision about whether to start treatment with biologics. Knowing what to expect can also help you decide whether to switch to biologics.
There is current scientific interest in and ongoing research into finding new forms of biologics. For now, healthcare professionals can administer them in only two ways: via injection or intravenously (through an IV).
You can receive training to do your own injections or have them done by a medical professional.
Intravenous doses, on the other hand, are only given by infusion in a clinical setting. This method can take several hours. Wear comfortable clothing, bring snacks and entertainment such as a book, and arrange to have a ride home afterward.
You can receive most intravenous biologics once every 8 weeks after the initial dose. On the other hand, biologics administered through injection typically need to be given every 14 days after the initial shot.
Because the only way to receive a biologic is through an injection or IV, you may experience some side effects from these treatment methods. Temporary pain at the injection site is one side effect, but others can include:
Make sure to talk with your doctor about any allergies you may have before opting for biologic treatment.
Biologics come with risks. According to
- Immunosuppression. Biologics can suppress your immune system and make it harder to fight off viruses and infections.
- Infections. Due to a repressed immune system, infection may happen more frequently.
- Psoriasis flare. On rare occasions, biologics may cause a flare-up or even the development of psoriasis.
- Arthritis. You may develop joint pain.
- Lupus-like reaction. You may experience rash, fever, muscle ache, and joint pain.
- Blood cancer and skin cancer. In rare cases, certain biologics can increase the risk of both blood cancers and skin cancers.
Depending on your case, the possible benefits of biologic medication may outweigh these risks. A healthcare professional can tell you more about the risks and help you make an informed decision about whether to take them.
If you stop taking biologics, they may not work as well when you start taking them again. This is because your body can build up antibodies that make the drug less effective.
This is one of the reasons that doctors recommend continued use of biologics even if your Crohn’s is in remission. Another reason is that biologics are effective at maintaining remission by protecting you from reacting to flare triggers.
In certain situations, such as before surgery, your doctor will recommend taking a medication break. In many circumstances, however, your doctor will likely recommend the consistent use of biologics.
Live vaccinations such as measles, mumps, and rubella (MMR) are not recommended once you start biologics because of the risk of infection that this medication presents.
If possible, make sure you’re up to date on all your vaccines before starting a biologic.
Biologics are relatively new. Because of this, the long-term effects on infants exposed to biologics during pregnancy aren’t known.
However, experts believe that the risk is low and conclude that the chance of fetal malformations while using biologics during pregnancy is close to that of the general population.
You and your doctor will need to discuss the risks of going off biologics during pregnancy versus the potential risk to your baby. It may be appropriate to take a medication break partway through your pregnancy depending on the type of biologic you are using.
Babies exposed in utero to certain biologic medication may need to avoid being immunized with live attenuated vaccines until they are at least 6 months old. Even then, they should be watched closely for signs of infection.
Biologics work by targeting and suppressing the inflammation response that can trigger Crohn’s flares. However, these medications come with side effects, including reduced ability to fight infection.
Talk with your doctor before deciding to take a biologic to make sure you have all the facts about that particular biologic and how it might affect you.
It’s also important to continue taking your biologic even while in remission unless instructed otherwise by your doctor.