Taking a Biologic for Crohn's Disease: Risks and Benefits
Biologics: Weighing the Risks and Benefits continued...
Swaroop says he looks for signs that the disease is progressing, such as how long between a person's diagnosis of Crohn's and when they have fistulas (breaks in the intestinal wall). "These are the patients who generally do better on biologics, who have the quality of life improvement, who are able to avoid surgery and get back in the workforce."
Before prescribing biologics, doctors check for potential problems. "In the beginning, of course, we go ahead and make sure the person does not have an active liver infection or TB," says Marie Borum, MD. She is a professor of medicine and director of the division of gastroenterology and liver diseases at George Washington University in Washington, D.C.
Once someone starts a biologic, the doctor looks for side effects in order to find them before they become serious. This monitoring includes lab tests and possibly regular skin checks for signs of skin cancer.
Risks and Rewards of Crohn's Treatment: The Bottom Line
All effective therapies for Crohn's disease come with some risk, Bloomfeld says. "It is not an option not to treat Crohn's, so we certainly need to weigh these risks against the benefits of having the disease well treated."
"It may be challenging for the individual to consider all of these risk and benefits. They need to work with their gastroenterologist to decide what might be most beneficial for them and what risk they are willing to accept to effectively treat Crohn's disease," Bloomfeld says. "You have to be willing to accept some risk to adequately treat Crohn's disease."