Treating Crohn's With Biologics: Drugs at a Glance

If you have moderate to severe Crohn’s disease and the first medicines you try don’t help enough, your doctor may consider “biologics,” which are a different type of medicine.

Biologics attack enzymes or proteins that inflame your intestine. They don't slow your whole immune system, as steroids tend to do. While they’re less likely to cause major problems, dangerous side effects are possible.

Several biologic drugs are approved to treat Crohn's disease. Five of them are “TNF-blockers”:

  • Adalimumab ( Humira ). You'll get this as a shot every 2 weeks.
  • Adalimumab-atto (Amjevita), a biosimilar to Humira. This medicine is given as a shot that you'll take every 2 weeks.
  • Certolizumab (Cimzia). You get this drug as a shot. After the first one, you get injections at 2 weeks and 4 weeks. After that you get a shot every 4 weeks.
  • Infliximab ( Remicade ). You take this drug through an IV. After your first IV dose, you'll get another IV dose at 2 weeks and 6 weeks. After that you'll get an IV dose every 8 weeks.
  • Infliximab-dyyb (Inflectra), which works like Remicade. Your doctor may call it a “biosimilar” medicine. You get it through an IV at your doctor’s office. This process will last at least 2 hours. After the first treatment, you will get more doses at 2 weeks and 6 weeks later. Then you’ll get a dose every 8 weeks.

Two other approved drugs work on a protein called integrin and block movement of inflammatory white blood cells:

  • Natalizumab (Tysabri). You’ll get this through an IV every 4 weeks.
  • Vedolizumab (Entyvio) is also given through an IV. After your first dose, you'll get another IV dose at 2 weeks and 6 weeks. After that you'll get a dose every 8 weeks.

Another drug that works in a different way blocks IL-12 and IL-23:

  • Ustekinumab (Stelara). This is given as an IV for your first dose. After your first IV dose, you will receive an injection under your skin 8 weeks later and then every 8 weeks.

 

 

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Side Effects

The side effects vary by the type of drug you take.

Common side effects for TNF-blockers -- Amjevita, Cimzia, Humira, Inflectra, and Remicade -- include::

Side effects at the injection site include:

Some serious side effects include:

Before you start to take any of these drugs, your doctor will check to see if you have tuberculosis (TB) and look for new signs of TB during treatment.

Common side effects for natalizumab and vedolizumab include:

Serious potential side effects include:

Natalizumab raises your risk of a rare brain infection that causes severe disability or death. If you take it, your doctor will follow your health closely.

Common side effects for Stelara include:

  • Upper respiratory infections
  • Headaches
  • Tiredness
  • Itching
  • Redness at the injection site

Serious potential side effects include:

  • Increased risk for infection, including TB
  • increased for risk for certain skin cancers
  • face or throat swelling
  • Reversible posterior leukoencephalopthy syndrome (RPLS)
WebMD Medical Reference Reviewed by Jennifer Robinson, MD on December 06, 2016

Sources

SOURCES:

American Academy of Allergy Asthma & Immunology: "Medications and Drug Allergic Reactions: Tips to Remember."

Amgen Prescribing Information, Amjevita.

Crohn's and Colitis Foundation of America: "Biologic Therapies," "Medications: Biologic Therapy," and "About Crohn's Disease."

FDA: “FDA approves Inflectra, a biosimilar to Remicade.” "Prescribing Information, Infliximab-dyyb (Inflectra)." “FDA approves Amjevita, a biosimilar to Humira.”

Stelara Prescribing Information. 

 

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