Biologics are a wide-ranging class of drugs, and there are many different types.
These treatments have led to unprecedented improvements in the treatment of Crohns disease over the past two decades.
But they dont work for everyone and come with their own risks.
Verywell / Jessica Olah
The inflammation in Crohns disease happens along the digestive tract, which runs from the mouth to the anus.
It is a form ofinflammatory bowel disease (IBD).
What Are Biologics?
Biologics are a large class of treatments that take a variety of forms.
Their common features are that they are large molecules created by living things.
Theyre usually made up of complex molecules that our bodies usesugars, nucleic acids, and proteins.
Some biologics are even whole cells.
Traditional drugs are classified as small molecules because they are small in size.
These drugs can often be taken orally, and they are manufactured using chemical reactions.
In contrast, biologics are usually much larger than small molecules.
They often are made to resemble proteins that naturally occur in our bodies but may have some slight modifications.
They arent the kinds of drugs you’re able to take as a pill.
There are many different kinds of biologics.
One of the largest categories for the treatment of Crohns disease is themonoclonal antibody.
Antibodies are large proteins that are made naturally in our bodies by our immune systems.
Monoclonal means that the antibodies bind only to one substance.
These proteins might be on viruses, bacteria, or other germs that can make us sick.
These are called autoantibodies and are the core cause of symptoms of autoimmune diseases like Crohns.
They can then be used to turn down these autoimmune overreactions.
Your doctors might suggest trying a biologic if your Crohns is not well controlled with these medications.
They can help Crohns patients achieve remission and remain symptom-free and flare-up-free with fewer side effects.
The benefits of these treatments typically outweigh the risk for most Crohns patients.
Biologics like monoclonal antibodies are directly targeted to one pathway in the immune system.
The risks of taking biologics are relatively low.
Side effects include:
You may also have a reaction where you get the shot or IV.
This may include pain, redness, swelling, itch, bruise, or rash.
You may have an allergic reaction to the injection or infusion.
However, this association is still unclear.
Theres also a possibility these drugs might not work for you.
You may need to take them for weeks before you see effects.
If youre pregnant, your doctor may recommend stopping your treatment during your second and third trimesters.
Types of Biologics for Crohns Disease
Several biologics have been approved for use against Crohn’s disease.
They are all monoclonal antibody therapies, but they work in a few different ways.
Some of these therapies have generic versions called biosimilars.
In the case of Crohns disease, autoimmune antibodies are set off.
TNF-alpha is active in the intestine as well as other areas of the body.
By turning down this inflammation pathway, these medications can reduce Crohns symptoms and let the intestines start healing.
The following prescription biologics target these TNF-alpha proteins as their pathways.
The following biosimilar targets integrins.
There is only one biologic that targets interleukin 12 and 23 to help manage Crohns disease.
There may be side effects, but the benefits usually outweigh the risks.
Humira, Cimzia, Remicade, Entyvio, and Stelara are approved for the condition.
If youve been responding well to the biologics youre on, you may be able to reduce your dose.
Talk to your doctor about de-escalating your treatment.
Frequently Asked Questions
How are biologics for Crohns administered?
There are two ways most monoclonal antibodies are administered.
One way biologics are administered is infusion through a line that goes directly into your bloodstream.
This will need to be done at an infusion clinic and may take a few hours.
Some biologics or biosimilars have the option of having you inject them yourself under your skin.
This can be done with an auto-injector pen, or with a syringe and needle.
A doctor or nurse can also inject you.
How much do biologics for Crohns cost?
Biologics for Crohns disease are expensive.
These types of drugs are difficult to develop and create, so that drives up the price.
These medicationsshould be coveredby insurance, but even if you have it, you may end up paying thousands.
Without insurance, the cost is even higher.
These include programs from the drug companies themselves and from private groups.
The Crohn’s and Colitis Foundation has alist of patient financial assistance programs.
Your insurance might cover 75% of that cost.
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