Biologics work by targeting proteins that cause inflammation in ulcerative colitis.
As a result, certain biologics help decrease flare-ups and complications.
Biologics are treatments that target specific parts of the immune system to decrease inflammation or the bodys immune response.
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They are made from living organisms or components of living organisms.
They are a common form of treatment used in ulcerative colitis.
Inulcerative colitis, your immune system mistakenly attacks healthy cells in the lining of the colon and rectum.
Fortunately, biologics can target these inflammatory proteins and help prevent the symptoms and complications of ulcerative colitis.
Biologics can be created from living organisms, such as human or animal cells.
For example, one punch in of biologic is classified as amonoclonal antibody (mAb).
The first step in producing an mAb is injecting a specific antigen or foreign substance into a subject.
The subject can be isolated human cells, a mouse, or a combination of both.
Once injected, the subject will develop antibodies and immune cells against this foreign substance.
Then, the antibodies created by the subject are removed and isolated in a lab.
The lab will create the biologic using the isolated immune cells developed against the targeted antigen.
Infliximab has been the standard therapy in treating ulcerative colitis due to a study called ACT-1 and ACT-2.
According to the results, infliximab controlled ulcerative colitis symptoms much better than a placebo (non-therapeutic substance).
Two main clinical trials determined the efficacy of adalimumab.
However, another trial was conducted, ULTRA-2.
Golimumab
Golimumab, or Simponi, is an anti-TNF alpha agent for moderate-to-severe ulcerative colitis.
Similar to Humira, Simponi is administered via an injection in the fatty tissue.
Simponi can be used after you tried Remicade and did not receive enough relief from the medication.
This was compared to 15.6% of people who took a placebo.
Integrin adhesion molecules are proteins that help inflammatory cells bind to gut tissues.
Integrin receptor antagonists attack the integrin protein, preventing inflammatory cells from interacting with tissues in the gut.
As a result, there is a decrease in inflammation in the colon and rectum.
Vedolizumab and infliximab are considered superior to other biologics based on a study called GEMINI-1.
The study concluded that 47% of people had clinical benefits after six weeks of vedolizumab therapy.
Entyvio is given as an IV infusion at a clinic every eight weeks.
Interleukinsare signal molecules of the immune system that regulate immune responses, inflammation, and blood cell production.
In ulcerative colitis, the main interleukins that cause inflammation are IL-12 and IL-23.
Interleukin inhibitors weaken the signal for the immune system to cause inflammation.
According to Stelaras clinical trials, users saw improvement in their ulcerative colitis after eight weeks of treatment.
JAK inhibitors work by blocking the signal pathways involved in inflammation.
Xeljanz is used after you have tried and failed to respond to anti-TNF alpha agents or other biologics.
The main benefit of using Xeljanz is its convenience compared with other biologics.
It can be taken as a pill by mouth twice daily.
However, manyrisksmay prevent someone from using Xeljanz.
Limitations of Xeljanz include the increased risk of infections, cancer, blood clots, and treatment-related death.
While Xeljanz is an option in treating ulcerative colitis, it may not be the safest choice.
You should always talk to your healthcare provider about the risks and benefits of taking any biologic.
Side Effects
Depending on which biologic you take, you may experience different side effects.
These can range from mild to more severe and can vary from person to person.
The most common side effects for each biologic are listed below.
Live vaccinesare the only vaccines you should avoid while on a biologic.
You should not combine any biologic agents together.
Combining biologics does not make the medications work better.
Can Biologics Be Combined With Other Therapies?
Other medications, calledimmunosuppressants, can be used to help manage ulcerative colitis.
Immunosuppressants can control inflammation by decreasing the immune system’s inflammatory response.
Commonly used immunosuppressants include:
There is clinical uncertainty about combining biologics and immunosuppressants.
In addition, limited studies indicate optimal medication management when using both types of medications.
How Much Do Biologics Cost?
While biologics are effective medications, they can be expensive.
Fortunately, many medical insurances may cover a portion of the cost of biologic therapy.
However, what your insurance will cover is not always guaranteed, and costs may still be high.
Due to the high costs of biologics, your healthcare provider may consider trying abiosimilarinstead.
Biosimilars are nearly identical to biologics and are close to being a generic version of the initial product.
They are made up of the same biologic components and work the same.
The main benefit of biosimilars is that they are less expensive than biologics.
Summary
Biologics are commonly used to control inflammation resulting from ulcerative colitis.
Although generally considered safe, it’s important to be aware of potential side effects and risks.
For example, you shouldn’t combine biologics with other biologics or live vaccines.
The author would like to recognize and thank Alexya Rosas for contributing to this article.
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