If you have ulcerative colitis (UC), you’ve probably heard of biologics, a relatively new treatment for the condition.
These conventional medications include:
- immunosuppressive drugs
With all 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?
Read on for more information on biologics and how they may be able to help you manage your UC.
Biologics are made out of antibodies that are laboratory grown. The natural properties of biologics can 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 inflammation that causes discomfort for those living with UC.
Biologics are able to target specific areas in the body, making them more effective for some people. By contrast, steroids or other drugs affect the entire body and may have unwanted side effects.
Three types of biologics used to manage UC are:
- 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). In people with UC, this protein causes inflammation in the:
Blocking this protein is important for UC remission. Anti-TNF agents are not only able to help you maintain remission, but some can also actually heal inflamed intestinal areas.
Anti-TNF agents for UC include:
- Infliximab (Remicade). This drug is used to treat moderate to severe UC that has not improved with other drugs or in people who cannot take other drugs. It comes as an infusion you receive through a vein. The process takes 2 hours. You’ll receive three doses over the first 6 weeks and then one dose every 8 weeks.
- Golimumab (Simponi). This injectable medication is typically recommended for treating UC in 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 the third injection, you’ll receive doses every 4 weeks.
- Adalimumab (Humira). This prescription medication is injected into the abdomen or the thigh for the treatment of 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 have not achieved remission, your doctor may have you stop this drug.
These medications block the protein on the surface of key inflammatory cells. This stops these cells from moving freely from the blood into body tissues.
Vedolizumab (Entyvio) is an IRA. This intravenous (IV) medication treats UC that has not responded to other UC treatments and in people who are trying to avoid taking 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.
The Food and Drug Administration (FDA) approved ustekinumab (Stelara), the newest biologic for UC, in October 2019. It targets the proteins interleukin-12 and interleukin-23 in particular.
It’s recommended for treating moderate to severe UC that has not improved with other treatments.
The first dose is administered as an IV infusion at your doctor’s office or clinic, a process that takes at least an hour. You’ll then get an injection every 8 weeks afterward.
You can perform the maintenance injections yourself, or your doctor can do them.
One of the biggest advantages of using biologics is that they target certain areas of inflammation in your body, rather than affecting your entire immune system the way steroids or immunosuppressants might. For some people, this targeted attack may mean less severe side effects and fewer side effects in general.
Biologics have also
However, one drawback of biologics is that they can be
Another potential issue of biologics is that many of them have to be administered via IV or injection. This can make taking them more complicated than taking a pill.
It’s also possible for biologics to stop being effective over time, in which case you will need to work with your doctor to find either another biologic to try or another form of medication.
Like most medications, biologics have possible side effects, including:
- a reaction, such as redness or swelling, at the injection site
- a severe allergic reaction (rare)
Some more serious risks include decreased immune system function that can leave you susceptible to infections. You may also be more likely to experience:
- liver problems
- a worsening of heart conditions
Talk with your doctor if you experience any side effects.
If you’re interested in trying a biologic, discuss all the pros and cons with your doctor.
If you’ve already tried other drugs to treat your UC without any benefit, you might be a great candidate for a biologic.