Treating Crohn’s: Choosing the Right Biologic
Which Biologic Is Right for You?
Most doctors choose anti-TNF biologics to start, Bloomfeld says. Tysabri is usually reserved for people who have not had a good response to these drugs.
When you choose a biologic, weigh how you'll need to get it -- and how often. For example, you get a Humira or Cimzia shot every two or four weeks. You take Remicade by IV every two months. Each IV session takes 2 to 3 hours at a doctor's office or IV center.
You might prefer the ease of a shot, which you can give yourself. On the other hand, you might prefer to get an IV in a medical setting, from a person trained to give it.
Questions to Ask Your Doctor
Like all drugs, biologics have pros and cons. Before you choose one, ask your doctor:
- How is the drug given? Will I need IVs, or can I give it to myself?
- Is this the only treatment I need, or will I have to take another drug along with it?
- How often will I need to take the drug?
- Where will I get IVs?
- Could I have a bad reaction? If so, how is it treated?
- How likely are side effects? How does that compare with other treatments?
- What are the pluses of taking a biologic? How do those compare with other options?
- Which biologic have you had the most success with?
You'll also want to ask yourself questions such as:
- Am I OK with giving myself shots? Is there someone who can give them to me if I have trouble?
- Can I commit to giving myself shots on schedule for a long time?
- Can I sit still for 2 or more hours for an IV? Can I take the time away from my work or family?
Weighing the Risks and Benefits
You'll need to consider possible side effects and risks with biologics along with the benefits. For example, your skin could get irritated at the area of the shot or IV. There are also increased risks of cytopenia (decrease in some types of blood cells) and infection. And there have been reports of neurologic disease, congestive heart failure, lung fibrosis, liver toxicity, skin reactions, and possible increased risk of cancer. Talk to your doctor about these rare but potential risks.