People with Crohn’s disease should aim for remission. Biologic therapies are a way to achieve remission. They can reduce symptoms and heal damage to the intestines from inflammation.
People with severe Crohn’s disease who have not found relief from other treatments may be prescribed biological therapies.
However, guidelines recommend that physicians prescribe biologics to patients with severe diseases as a first-line treatment.
Biologic therapies block certain chemicals that can cause inflammation in the intestines.
The majority of biologics for Crohn’s disease block the protein tumor necrosis factors (TNF). Others biologics can block immune cells called integrins and others work on proteins interleukin-23 and interleukin-12. This is how biologic therapies can stop inflammation in the stomach.
Humira
After a demonstration from a healthcare professional, Humira can be self-administered.
If your doctor feels you are able to inject yourself, they will give you a set with dose-controlled medication.
Instructions will be provided on how many injections you should take in the first 30 days. Patients typically only need one Humira pen after the initial 30-day period.
Remicade
Remicade may help people better manage flare-ups. Remicade may help to maintain remission and prevent symptoms from returning.
Remicade can be administered directly to the bloodstream. This allows it to immediately relieve symptoms.
The treatment is administered in a hospital. To monitor side effects, experienced healthcare professionals will be on hand to assist you during and after your treatment.
Remicade does not have to be taken daily. A person can see the benefits of Remicade in as little as three doses.
Cimzia
Cimzia can be administered by a small injection. You can have the injection at your doctor’s office, or at home.
You have the option to receive your treatment in powder form if you prefer to be treated in your doctor’s offices. The powder is mixed in sterile water before being injected.
Prefilled syringes are another option. These syringes have medication already mixed in precise doses. These can be used at your home or in the doctor’s office.
If you decide to perform the treatment yourself, you will receive a package that includes two syringes as well as instructions for how to administer it.
You can now take Cimzia once a week after the initial three doses. These are given every two weeks.
These are the two anti-integrin biologics that Crohn’s sufferers can use:
- Tysabri
- Entyvio
Tysabri
This biologic blocks a protein at the cell’s surface that causes inflammation to prevent white blood cells from entering tissues.
Tysabri intravenously is administered every four weeks. The full dose takes approximately one hour.
Usually, you’ll be observed for at least an hour. Tysabri is used to treat people who are unable or unwilling to take a TNF inhibitor, immunomodulator or corticosteroid.
Tysabri is not recommended for people with Crohn’s disease.
Tysabri users are at greater risk of a rare brain disorder called progressive multifocal leukoencephalopathy. (Trusted Source). This is due to a virus that can be tested in advance.
Tysabri for Crohn’s is prescribed by healthcare providers. You will also be explained how to join the TOUCH prescribing program. This is the only way to receive Tysabri.
Entyvio
Entyvio, like Tysabri is approved for adults with moderate to severe Crohn’s disease. It can be used to treat those who are unable to take, intolerant to or have other medical reasons, a TNF inhibitor, immunomodulator or corticosteroid.
It acts in a similar way to Tysabri by acting on certain white cells to stop them from causing Crohn’s-related bowel inflammation.
Entyvio is however gut-specific, and does not appear to carry the same PML risk.
As an intravenous injection, Entyvio will be administered by a doctor. It is administered over 30 minutes the first day. The process is repeated every 8 weeks, on week 2, week 6, and week 6.
Entyvio therapy should not be continued if Crohn’s disease symptoms do not improve by week 14. Before you start Entyvio, ensure that your immunizations are current.
Stelara
The IL-12 and IL-23 agonists are the third category of biologics.
Stelara is the approved drug for adults with Crohn’s disease, moderate to severe. It’s used to treat those who have not responded to traditional therapy.
The drug targets proteins that are key in inflammation.
Stelara is administered intravenously first under the supervision and guidance of a healthcare professional.
These doses may be administered by an injection under the skin once every 8 weeks by a healthcare professional or self-administration after you have been trained.