Skip to content

    Inflammatory Bowel Disease Health Center

    Font Size
    A
    A
    A

    Treating Crohn’s: Choosing the Right Biologic

    By Mary Anne Dunkin
    WebMD Feature

    If your doctor has talked about using biologic drugs to treat your Crohn's disease, you want to learn as much as you can about them. This guide to biologics includes some questions to ask your doctor and yourself. Use it to help you choose the treatment that's right for you.

    What Are Biologics?

    Unlike some Crohn's drugs, which suppress your whole immune system, biologics are antibodies that target particular proteins and cells and then block the process that causes inflammation in your gut. So you can get relief while avoiding some of the big side effects of other drugs.

    Cimzia (certolizumab pegol), Humira (adalimumab), and Remicade (infliximab) are called anti-TNF-alpha antibodies because they block a protein called tumor necrosis factor-alpha.

    Tysabri (natalizumab) prevents white blood cells from traveling to the inflamed gut area and causing more damage.

    Should You Take a Biologic?

    It depends largely on:

    • How severe your Crohn's is
    • What other treatments you've tried
    • Your doctor's treatment approach
    • What you prefer

    When to Take a Biologic -- Sooner or Later?

    Some doctors use "step-up therapy." They suggest a biologic only if you have moderate to severe active disease, and standard Crohn's drugs have not worked well for you.

    Why use standard drugs first? "We know how they work, what to expect, and because of our comfort level with them, we tend to use them first," says Marie Borum, MD, professor of medicine and director of gastroenterology and liver diseases at George Washington University in Washington, DC. If you use a biologic early, she adds, you exhaust your treatment options up front.

    Others doctors prefer to prescribe biologics from the start. "The trend is to use biologics early, with the hope of altering the history of disease," says Richard Bloomfeld, MD, associate professor of medicine and director of the inflammatory bowel disease clinic at Wake Forest University School of Medicine in Winston-Salem, NC. You may be able to avoid taking steroids that can have many serious side effects. And you may be able to avoid complications and delay the need for surgery.

    Most doctors agree that people should start biologics sooner rather than later if they have severe Crohn's. Your doctor may suggest one if:

    • You were young when you got Crohn's
    • Your small intestine is involved
    • You use steroids often to control symptoms
    • You smoke
    • Ulcers have made "fistulas," which are passages through two organs or parts of your body, like two parts of your intestine

    Today on WebMD

    woman with pains in abdomen
    Get personalized tips.
    doctor talking with female patient
    10 questions for your doctor.
     
    woman clutching at stomach
    Causes, symptoms, treatments, and more.
    butter curls
    What to eat and avoid.
     
    Living With Crohns Slideshow
    Slideshow
    Ulcerative Colitis Surgery Slideshow
    Slideshow
     
    crohns disease healthcheck
    Tool
    Ulcerative Colitis Health Check
    Tool
     
    Crohns Symptoms
    Quiz
    Ulcerative Colitis Diet
    Slideshow
     
    Crohns Prebiotic
    Article
    woman holding stomach
    Article