Reviewed By: Pramod Kerkar, MD, FFARCSI

Crohn's disease is an autoimmune disease that affects the digestive tract. It is a chronic inflammatory bowel disease that causes irritation to the digestive tract. Inflammation caused to the digestive tract from Crohn's can cause several problems such as diarrhea, bloody stools, severe abdominal pain, malnutrition, weight loss, and fatigue. Crohn's disease can affect any part of your gastrointestinal tract, but it typically affects the end of the small intestine, the colon, or both. There is no cure for the disease but treatments are available for managing the symptoms. Sometimes, if your doctor feels that your current Crohn's treatment is not working for you, then your doctor may decide to try biologics. Biologics are a type of antibiotic that targets certain proteins and cells in the body to block the process that causes inflammation in the first place.

This provides some much needed relief to those who are suffering from abdominal pain and the other related symptoms of Crohn's disease. Biologics also do not have many of the side effects associated with other medications used in Crohn's. So do biologics really work for Crohn's disease? Let's take a look.

What are Biologics in The Treatment of Crohn’s Disease?

Biologics are a separate class of drugs that can be used to relieve many of the symptoms of Crohn's disease. These drugs are also helpful in keeping you in the remission phase of the disease. If your doctor notices that your current treatment is not working properly, then he/she may consider prescribing biologics. Biologics are also often prescribed when you suffer from moderate to severe Crohn's disease that is not responding to any other treatments.

However, just like with any other medication, you need to carefully weigh the benefits and side effects of biologics before you begin the treatment. Biologics can help lower your inflammation and also stall the progression of your condition. However, taking biologics also puts you at a higher risk of catching other infections and even increases the chance of getting certain cancers.

This is why many doctors only use biologics when other therapies do not work. On the other hand, some doctors opt for an approach of beginning the treatment with biologics so that intestinal damage can be stopped or controlled even before it begins.

Being aware of the risks and benefits of biologics will help you determine if biologics will work for your particular situation.

Will Biologics Work On Me?

Whether or not you should take a biologic and whether it will work on you depends on many factors. These include:

  • What treatments have you already tried?
  • What is the severity of your Crohn's?
  • What is your doctor's treatment approach?
  • What course of treatment will you prefer?
  • When Should You Take A Biologic For Treating Crohn’s Disease?

Most doctors prescribe biologics if you have severe Crohn's. Apart from this, some considerations your doctor may keep in mind for prescribing biologics include:

  • You got Crohn's at a young age
  • The disease has affected your small intestine
  • You are using steroids to control your symptoms
  • You are a regular smoker

Due to the condition, you have got ulcers which have made passages through two or more parts of your body, for example, two parts of the intestine
Many doctors also start the treatment with standard drugs. This is because doctors are more comfortable with how these standard medications work, what to expect from the treatment, and also because there is a certain comfort level associated with using these medications. Furthermore, there is a belief that if you begin using a biologic early on itself, then you end up exhausting your treatment options at the beginning itself.

On the other hand, many doctors begin the treatment with biologics as they want to avoid the side effects of steroids and other medications. Biologics are also known to avoid complications and also delay the need for surgery.

The overall verdict, though, is that most doctors agree that people should begin their treatment with biologics rather than at a later stage.

What are the Side Effects of Biologics?

Since biologics work by suppressing the immune system, there is always a higher risk of infections attached to taking biologics. In some rare cases, this can prove to be serious. As of today, there are only four biologics that are actually approved by the US Food and Drug Administration (FDA). These include:

  • certolizumab (brand name: Cimzia)
  • adalimumab (brand name: Humira)
  • infliximab (brand name: Remicade)
  • natalizumab (brand name: Tysabri)

Some of these biologics even carry a warning on their boxes for an increased risk of getting serious infections that may even cause death or hospitalization.
In cases where taking a biologic drug leads to a serious infection, the drug should be discontinued immediately. People suffering from tuberculosis, multiple sclerosis, or heart failure, should not take biologics as it can worsen their condition.

Some of the other side effects of using biologics may include:

Do Biologics Work?: Weighing Its Risks and Benefits in Crohn’s Disease Treatment

Before prescribing biologics, doctors will always weight the potential risks against the benefits they hope to achieve from this treatment. While doctors may vary on deciding at which stage to start biologics, there is a general agreement that biologics for Crohn's disease is used when the condition is severe. Doctors also look for signs that indicate the progression of the disease.

Once the treatment is started, doctors will continue monitoring a patient for side effects in order to determine whether the treatment with biologics is working or not. This monitoring will include regular lab tests and skin checks for skin cancer indications.

It is a known fact that all treatments for Crohn's disease carry a certain risk. However, biologics are being seen as a treatment that is beneficial for most. However, always consider the potential side effects that are attached to biologics and weigh them against the benefits. Biologics will prevent the inflammation from occurring, which will provide you with relief from the general symptoms of Crohn's.

It is best to discuss the pros and cons with your doctor and then make an informed decision about whether or not you want to opt for biologics for treating Crohn's disease.

Also Read:

References

  1. Cohen, R.D., 2014. Biologics in Crohn’s Disease. Advanced Therapy of Inflammatory Bowel Disease, Volume 2: IBD and Crohn's Disease, 2, p.699.
  2. Ghosh, S., Goldin, E., Gordon, F.H., Malchow, H.A., Rask-Madsen, J., Rutgeerts, P., Vyhnálek, P., Zádorová, Z., Palmer, T. and Donoghue, S., 2003. Natalizumab for active Crohn's disease. New England Journal of Medicine, 348(1), pp.24-32.
  3. Sandborn, W.J., Colombel, J.F., Enns, R., Feagan, B.G., Hanauer, S.B., Lawrance, I.C., Panaccione, R., Sanders, M., Schreiber, S., Targan, S. and Van Deventer, S., 2005. Natalizumab induction and maintenance therapy for Crohn's disease. New England Journal of Medicine, 353(18), pp.1912-1925.
  4. Colombel, J.F., Sandborn, W.J., Reinisch, W., Mantzaris, G.J., Kornbluth, A., Rachmilewitz, D., Lichtiger, S., D'haens, G., Diamond, R.H., Broussard, D.L. and Tang, K.L., 2010. Infliximab, azathioprine, or combination therapy for Crohn's disease. New England Journal of Medicine, 362(15), pp.1383-1395.
Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: September 19, 2018

This article does not provide medical advice. See disclaimer

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