Which Biologics Are Used to Treat Crohn's Disease?

Biologics are prescription drugs made from living organisms. Your doctor may prescribe one to you if other treatments haven’t worked.

Biologics work on your immune system. They target specific proteins in your body that cause inflammation.

The FDA has approved these biologics to treat Crohn’s disease:

  • Adalimumab (Humira)
  • Adalimumab-atto (Amjevita), a biosimilar to adalimumab
  • Certolizumab pegol (Cimzia)
  • Infliximab (Remicade)
  • Infliximab-abda (Renflexis), a biosimilar to infliximab
  • Infliximab-dyyb (Inflectra), a biosimilar to infliximab
  • Natalizumab (Tysabri)
  • Vedolizumab (Entyvio)

Adalimumab, adalimumab-atto, certolizumab pegol, infliximab, infliximab-abda, and infliximab-dyyb target a protein called TNF-alpha that's part of the inflammation process.

Natalizumab blocks certain white blood cells that lead to inflammation.

Vedolizumab stops the cells from crossing the blood vessels' walls into inflamed areas of your gastrointestinal tract.

Adalimumab (Humira), Adalimumab-atto (Amjevita)

These drugs may lessen symptoms of moderate to severe Crohn’s disease. It may also help keep them from coming back.

How’s it given: You get it by a shot under the skin.

What are the most common side effects?

  • Redness, swelling, itching, pain, rash, or bruising of the skin where you got the shot
  • Upper respiratory or sinus infections
  • Headache
  • Nausea

What are some other potential side effects? All biologics share the potential for serious side effects, including infections like tuberculosis and sepsis. These drugs don't cause tuberculosis, but they may trigger it in people already exposed to the disease.

A few people have gotten cancers like lymphoma.

Certolizumab pegol (Cimzia)

This drug reduces symptoms of moderate to severe Crohn’s disease. It also helps to keep them from returning.

How’s it given: You get it by a shot under the skin.

What are the most common side effects?

  • Rash
  • Swelling
  • Joint pain
  • Upper respiratory tract infection
  • Urinary tract infection

What are other potential side effects? You may be more likely to get tuberculosis and sepsis.

Your odds of getting other infections may be higher than most. Tell your doctor right away if you have an infection, or if you have a cough, fever, fatigue, or the flu. In rare cases, people have developed cancers like lymphoma.

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Infliximab (Remicade), Infliximab-abda (Renflexis), Infliximab-dyyb (Inflectra)

These drugs can lessen your symptoms. They may also help heal and reduce your number of fistulas. These are sores that form tunnels between parts of your intestines, or from the intestines to your organs or skin. They often become infected and drain pus, mucus, or stool.

How’s they're given: You get them by IV.

What are the most common side effects?

  • Redness, swelling, itching, pain, rash, or bruising of the skin at the site of your IV
  • Upper respiratory or sinus infections
  • Sore throat
  • Headache
  • Rash
  • Nausea
  • Coughing
  • Stomach pain

What are other potential side effects? Like other biologics, there’s a potential for serious infections, such as tuberculosis and sepsis. It’s rare, but some people have gotten cancers like lymphoma.

Natalizumab (Tysabri)

Your doctor may recommend this drug if you have moderate to severe Crohn's disease with signs of inflammation. If you take it, don’t use other biologics or other drugs that block your immune system.

How’s it given: You get it by IV.

What are the most common side effects?

  • Upper respiratory infections
  • Urinary tract infections
  • Headache
  • Depression
  • Fatigue
  • Diarrhea
  • Stomach pain
  • Rash

What are other potential side effects? This drug raises the risk of a rare but potentially fatal brain infection called progressive multifocal leukoencephalopathy (PML). It can also cause allergic reactions and liver damage.

Vedolizumab (Entyvio)

It’s used to treat moderate to severe Crohn’s disease.

How’s it given: You get it by IV.

What are the most common side effects?

  • Upper respiratory infections
  • Headache
  • Joint pain
  • Nausea
  • Fatigue
  • Fever
  • Rash
  • Pain in your hands and feet

What are other potential side effects? Like other biologics, vedolizumab may raise your odds of getting a serious infection like tuberculosis or sepsis. There’s an added risk of allergic reactions, liver damage, and a rare but potentially fatal brain infection called PML.

Work Closely With Your Doctor

If your doctor prescribes a biologic, she'll keep close tabs on you to be sure the treatment works safely and effectively. So keep all appointments for lab work and doctor visits.

Tell your doctor about all prescription and over-the-counter drugs you take, as well as any supplements or natural remedies. Anything you take can affect the way other medications or supplements work. Don’t take anything new without talking to your doctor first.

Also, tell your doctor about all of your medical conditions. Let her know if your symptoms get worse or if you notice any new ones.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on December 07, 2016

Sources

SOURCES:

American College of Gastroenterology, Practice Guidelines: "Management of Crohn's Disease in Adults."

Amgen Prescribing Information, Amjevita.

Crohn's and Colitis Foundation of America: "Biologic Therapies," "Understanding IBD Medications and Side Effects."

FDA. “FDA approves Amjevita, a biosimilar to Humira.”

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