Most people do not know what biologics are, as they are a relatively new treatment for patients with Inflammatory Bowel Disease (IBD). I’m sure you’ve seen the commercials, but you’re probably left wondering how they actually work. Biologics are protein-based antibodies used to stop certain proteins in the body from causing inflammation. Biologics are typically administered through injection or infusion. This type of medication is used only if other treatments have failed. To learn more about how biologics work, watch the video below.
In this blog, I will go over three of the common biologics being used to treat IBD.
1. Adalimumab (Humira)
Humira is one of those drugs that you see probably way too many commercials for and think “what the heck is that?” Humira not only treats IBD, but many other inflammatory diseases including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, chronic plaque psoriasis, and more. It is administered by injection and typical dosage is every other week following the loading dose. In some cases, dosage can be weekly. Humira is not a medication that will yield immediate results – symptom relief can take 8 weeks or more.
2. Infliximab (Remicade)
Remicade is used to treat Crohn’s disease, ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis. Many of these biologic medications are considered TNF-alpha blockers. TNF-alpha is the protein that causes inflammation, so many of these chronic illnesses cause your body to produce too much TNF-alpha and your immune system attacks itself. Remicade is administered through an IV infusion. There are three starter doses at week zero, two, and six, followed by one maintenance dose every eight weeks.
3. Ustekinumab (Stelara)
Stelara treats both IBD and some forms of arthritis. Stelara specifically targets two proteins found in the gut, making it a very good option for patients with IBD. It is administered through a one-time IV infusion followed by an injection every eight weeks. The appeal with Stelara is that it requires less overall injections than Humira and also specifically targets the gut so it seems like results may be better or faster.
When I was diagnosed and continuing to experience flares, these were the three options I was given by my doctor. I did a lot of research on each one looking for what may be the best option for me. The scariest part about starting a biologic, besides the side effects and risk factors, is the risk that it may not work. Each person is different and you invest a lot of time in taking a medication like this, so you want it to work. Patience and trusting the process is key.
I have been on Humira for three years and it wasn’t an easy decision to make. At the end of the day, I decided that the risks of not addressing my active inflammation were larger than starting this medication. While I didn’t see immediate improvement on a bi-weekly schedule, I did see major improvement on a weekly dosage. It was the extra puzzle piece I needed to get into remission. If you are looking for an overnight solution, this is not it; but if you are looking for that extra boost, a biologic may be the way to go. Your specific situation should be discussed with your doctor first.
If you have IBD, what has been your experience with biologics if any?