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Inflammatory Bowel Disease Health Center

Taking a Biologic for Crohn's Disease: Risks and Benefits

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By Mary Anne Dunkin
WebMD Feature

Biologics are a class of drugs that can relieve your Crohn's symptoms and keep you in remission. Your doctor may prescribe them if you have moderate to severe Crohn's that doesn't respond to other treatments. As with all drugs, you need to weigh the risks and benefits.

Biologics and Side Effects

Because they suppress the immune system, all biologics carry an increased risk of infections, which in rare cases can be serious. Four biologics are approved by the FDA to treat Crohn's:

  • Cimzia (certolizumab)
  • Humira (adalimumab)
  • Remicade (infliximab)
  • Tysabri (natalizumab)

Cimzia, Humira, and Remicade carry a boxed warning for increased risk of serious infections that could lead to hospitalization or death. If someone taking a biologic develops a serious infection, the drug should be discontinued. People with tuberculosis, heart failure, or multiple sclerosis should not take biologics, because they can make those conditions worse.

Cimzia, Humira, and Remicade are a type of drug called a TNF inhibitor. In rare cases, some people taking TNF inhibitors have developed certain cancers such as lymphoma.

Tysabri increases the risk of a very rare but potentially fatal brain infection called progressive multifocal leukoencephalopathy (PML). Tysabri also can cause allergic reactions and liver damage. It should not be used at the same time as other treatments that suppress the immune system or TNF inhibitors.

Most infections that occur with biologic use are far less serious, though, says Richard Bloomfeld, MD. He is an associate professor of medicine and director of the inflammatory bowel disease program at Wake Forest University School of Medicine. "Infections such as colds, upper respiratory tract infections, and urinary tract infections are common and don't necessarily alter our treatment of Crohn's," he says.

Other common side effects from biologic use include:

  • Headache
  • Flu-like symptoms
  • Nausea
  • Rash
  • Injection site pain
  • Infusion reactions
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