Overview

If you have ulcerative colitis (UC), you’ve probably heard of biologics, a relatively new treatment for the condition.

While the goal of any UC drug therapy is to help you achieve and maintain remission, 20 to 40 percent of people simply don’t respond to conventional UC medications. These drugs include aminosalicylates, steroids, and immunosuppressive drugs.

With all of the buzz around biologics, it can seem hard to sort out the key facts. What are these drugs? What do they do exactly? Which biologic might be right for you?

Consider the following your road map to biologic success.

Biologics are made out of antibodies that are grown in a laboratory. The natural properties of biologics are able to stop certain problem proteins in the body from causing inflammation.

Think about biologics as tiny, human-made “soldiers.” When they’re injected into the body, they fight off the inflammation that causes so much discomfort for those living with UC.

Biologics are able to target specific areas in the body, making them even more enticing. By contrast, steroids or other drugs treat the entire body and may have unwanted side effects.

Three types of biologics include:

  • anti-tumor necrosis factor (anti-TNF) agents
  • integrin receptor antagonists (IRAs)
  • interleukin (IL) inhibitors

Anti-TNF agents bind to and block the protein called tumor necrosis factor-alpha (TNF-alpha). This protein causes inflammation in the intestines, organs, and tissues of people with UC.

Blocking this protein is important for UC remission. Anti-TNF agents have not only helped people maintain remission, but some can actually heal inflamed intestinal areas.

Anti-TNF agents for UC include:

  • Adalimumab (Humira). This prescription medication is injected into the abdomen or the thigh of those with moderate to severe UC. After your doctor shows you how to use this drug, you can administer it at home every 2 weeks. Your doctor will check in with you at 8 weeks. If you haven’t achieved remission, you may need to stop this drug.
  • Golimumab (Simponi). This injectable medication is typically recommended for people who are having trouble stopping the use of steroids. It can be administered at home or by your doctor. You usually receive two injections on your first day and one injection 2 weeks later. After this third injection, you’ll receive doses every 4 weeks.
  • Infliximab (Remicade). This drug is for people with moderate to severe UC that hasn’t improved with other drugs or people who can’t take other drugs. It comes as an infusion you get through a vein, and the process takes 2 hours. You’ll get three doses over the first 6 weeks, and then one dose every 8 weeks.

These medications block the protein on the surface of key cells that cause inflammation. This stops these cells from moving freely from the blood into body tissues.

Vedolizumab (Entyvio) is an IRA. This intravenous (IV) medication treats people who haven’t responded to any other UC treatments and are trying to not take steroids.

The infusion process takes about 30 minutes. You get three doses in the first 6 weeks of treatment, followed by one dose every 8 weeks.

This type of biologic targets proteins that are involved in the process that leads to inflammation.

Ustekinumab (Stelara), the newest biologic for UC, was approved by the Food and Drug Administration (FDA) in October 2019. It targets the proteins interleukin 12 and interleukin 23 in particular.

It’s recommended for adults with moderate to severe UC that hasn’t improved with other treatments.

The first time you get it as an IV infusion at your doctor’s office or clinic, a process which takes at least an hour. Then you get an injection every 8 weeks afterward.

For the most part, biologics are only introduced as an option for treating UC when the first course of treatments has been exhausted.

Keep in mind that biologics have possible side effects, such as:

  • headaches
  • nausea
  • fever
  • sore throat

Some more serious risks decreased immune system function that can leave you susceptible to infections. You may also be more likely to develop:

  • lymphoma
  • liver problems
  • worsening of heart conditions
  • arthritis

Talk to your doctor if you experience any side effects.

If you’re interested in trying a biologic, discuss all of the pros and cons with your doctor. If you’ve already tried other drugs without any benefit, you might be a great candidate for a biologic.