Bologic response modifiers, or biologics, are a group of medications for Crohn's disease that work by controlling the disease itself.
The following biologics are available in Canada to treat Crohn's disease:
Your body makes a substance called tumour necrosis factor alpha (TNF-α), which is an important part of your immune system and body's defences. Research shows that some Crohn's disease sufferers have too much TNF-α in their bodies. Instead of helping the body fight off infections, the excess TNF-α attacks other substances it perceives as foreign, leading to inflammation in the lining of your digestive system, which is a key part of Crohn's disease.
The biologics work by binding to and inactivating a TNF-α to help bring Crohn's disease under control.
Adalimumab (Humira®) is used to bring on and maintain remission in people with moderate to severe Crohn's disease when they have not responded to other treatments. Adalimumab is given as a subcutaneous (under the skin) injection using a prefilled syringe or prefilled pen device. A health professional can teach you how to give yourself the injections at home.
Adalimumab (Humira®) is given as a subcutaneous (under the skin) injection. The numbers indicate the regions where you can inject the medication.
Subcutaneous injection of adalimumab (Humira®) using a prefilled syringe.
Infliximab (Remicade®) is given as an intravenous infusion. Infusions are given at infusion clinics under the supervision of a health professional.
Infliximab (Remicade®) is used to bring on and maintain remission in people with moderate to severe Crohn's disease when their condition has not responded to other treatments. It is also used to treat a type of Crohn's disease called fistulizing Crohn's disease when it has not responded to other treatments.
Infliximab (Remicade®) is given as an intravenous (IV - meaning into a vein) infusion. Infusions are given at infusion clinics under the supervision of a health professional. The infusion procedure usually takes a few hours to complete.
Side effects for biologics include headache, infections, nausea, vomiting, diarrhea, nervous system problems (e.g., numbness or tingling, vision changes, dizziness, or weakness in the legs), abdominal pain, joint pain, fatigue, and injection-site or infusion reactions.
Serious infections may occur in people taking biologics such as adalimumab and infliximab, as these medications can lower your ability to fight off infection.
Tuberculosis is one of the serious infections that patients taking biologics are at greater risk of compared to the general population. For this reason, people are assessed for their risk of tuberculosis before starting treatment.
Biologics may also increase the risk of developing tumours and certain types of cancer. Rarely, people have developed cancer, including non-melanoma skin cancer and lymphoma (cancer that affects white blood cells in the lymph system). Very rarely, an often-fatal form of lymphoma called hepatosplenic T-cell lymphoma has occurred in people using biologics along with medications, azathioprine or 6-mercaptopurine.
Before prescribing these medications, your doctor will discuss all other side effects with you.
Your doctor may recommend regular blood tests and checkups while you are taking biologics. Ask your doctor what side effects you should watch out for and which need to be reported to your doctor.
It important to meet with your doctor on a regular basis to track your progress.
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