Treating ulcerative colitis has two main goals: helping to subdue your flare-up and maintaining it so you have fewer flare-ups. Biologics are among the newest drugs available for treating ulcerative colitis. They can be especially helpful for those who haven’t found relief yet.

What are biologics?

Biologics are a class of genetically engineered drugs that are made from living organisms. They help to suppress inflammation throughout your body by targeting proteins related to inflammation, like cytokines.

Corticosteroids suppress the entire immune system. Biologics are different from corticosteroids and other common treatments because they specifically target problematic proteins and enzymes.

Biologics are administered through IV infusion or injections at a doctor’s office or at home. The dosing schedule varies by medication. You can use them in combination with other treatments. A combination of biologics, steroids, and lifestyle changes is successful for many people.

Biologics currently FDA approved and available

There are four biologic medications currently FDA approved for the treatment of ulcerative colitis.

Adalimumab (Humira)

This is a monoclonal antibody that blocks an inflammation-causing protein called tumor necrosis factor alpha (TNF-α). It was originally approved for moderate to severe rheumatoid arthritis. More recently, it was approved for the treatment of moderate to severe ulcerative colitis. However, it has other indications including:

  • Crohn’s disease
  • plaque psoriasis
  • hidradenitis suppurativa
  • polyarticular juvenile idiopathic arthritis
  • ankylosing spondylitis

This medication is given by injection, starting with 160 milligrams (mg). A 80-mg dose is given two weeks later. Injections of 40-mg are given every other week thereafter. These can be administered at home.

The drug is for adults who haven’t responded to treatments with immunosuppresants.

You can give yourself this injection or your doctor may give it to you.

Golimumab (Simponi)

Simponi may be right for you if you’re corticosteroid-dependant or if you’ve had a poor response to other medications.

This medication is given by injection, starting with a 200-mg dose. A 100-mg dose is given two weeks later. Injections of 100-mg are given every four weeks thereafter. They can be administered at home.

Infliximab (Remicade)

This medication is approved to treat moderate to severe ulcerative colitis in those who haven’t responded well to other treatments. One IV dose is given to start. Another dose is given at week two, and another at week six. After that, it’s given once every eight weeks.

Vedolizumab (Entyvio)

This medication is one of the most recently approved biologics on the market for ulcerative colitis. It’s also for those who haven’t been able to tolerate or didn’t respond to other treatments. It’s administered through a 30-minute IV infusion. One dose is given to start. Another dose is given at week two, and another at week six. After that, it’s given once every eight weeks.

What you should know

Biologics may cause side effects. The most common side effects are redness, itching, bruising, and pain at the injection site.

Other possible side effects include:

  • headache
  • chills
  • fever
  • hives
  • low blood pressure
  • breathing difficulties
  • rash
  • nausea
  • stomach pain
  • back pain

Biologics can interfere with your body’s ability to fight infection. Some serious infections that have been reported with their use include:

  • tuberculosis (TB)
  • sepsis
  • a rare brain infection called progressive multifocal leukoencephalopathy (PML)

You’ll need to take a TB test before you start biologic therapy. Talk to your doctor immediately if you have any sign of infection while taking one of these medications.

Biologics may increase your risk of developing certain cancers, including lymphoma. You shouldn’t take biologics if you suffer from heart failure or liver disease.