Anti-tumor Necrosis Factor Agents | Integrin Receptor Antagonists | Anti-interleukin Therapy | Small Molecule Drugs | For More Information
Biological agents for inflammatory bowel disease (IBD) target specific proteins involved in the inflammation seen in conditions such as Crohn’s disease and ulcerative colitis. Created from laboratory-grown antibodies, biologics precisely reduce inflammation in areas of the immune system that are overactive. Unlike other drugs that may affect the whole body and lead to potential side effects, biologics only go to work where they are needed.
Advances continue to make biologics safer and more effective. Increasingly, biologic therapy is becoming the standard of care for many patients with moderate to severe IBD. Today, some 30 to 50 percent of individuals with IBD will likely be treated with a biological agent to stop the progression of their disease and achieve remission and relief from their symptoms.
At the NorthShore IBD Center, our GI specialists have extensive experience with the growing number and variety of FDA approved biologic therapies now available for treating IBD. We provide patients with a wide range of the latest treatment options, including anti-tumor necrosis factor agents, integrin receptor antagonists and anti-interleukin therapy.
Anti-tumor Necrosis Factor Agents
This class of biologic blocks a protein known as tumor necrosis factor (TNF-alpha) that causes intestinal inflammation. Among these medications are:
- Adalimumab (Humira®) for severe Crohn’s disease and ulcerative colitis. Given via subcutaneous injection, adalimumab is typically self-administered at home once every two weeks.
- Certolizumab pegol (Cimzia®) for moderate to severe Crohn’s disease. A self-injected biologic, it requires ongoing injections once a month.
- Golimumab (Simponi®) for moderate to severe ulcerative colitis. Typically used for patients whose disease has not responded to other treatments or they need to reduce steroid use. It is usually administered by self-injection once a month.
- Infliximab (Remicade®) for moderate to severe Crohn’s disease and ulcerative colitis in children and adults. Infliximab involves IV infusions at an infusion center every six to eight weeks.
- Infliximab-dyyb (Inflectra®) for moderate to severe Crohn’s disease in children and adults, as well as for adults with moderate to severe ulcerative colitis. A biosimilar to Remicade®, it is given by IV infusion at an infusion center typically every two months.
Integrin Receptor Antagonists
These biologic agents stop inflamed cells from moving out of blood vessels and into tissues by blocking integrin protein receptors on the intestinal lining. These medications include:
- Vedolizumab (Entyvio™) for moderate to severe Crohn’s disease and ulcerative colitis in individuals who can’t tolerate anti-TNF biologics or need to be weaned off corticosteroids. This therapy involves IV infusion at an infusion center every two months.
Anti-interleukin drugs go after naturally occurring proteins such interleukin (IL) that are involved in the inflammatory process. Often patients with Crohn’s disease have high levels of IL-12 and IL-23. Effective biologics in this class of drugs include:
- Ustekinumab (Stelara®) for moderate to severe Crohn’s disease. After a one-time IV infusion, self-administered maintenance injections are required every eight weeks.
Biologics continue to revolutionize the treatment of IBD and better personalize care to your specific needs. Our knowledgeable gastroenterologists can provide you with the critical therapeutic monitoring and care required to optimize outcomes with these advanced biological therapies.
Janus Kinase Antagonists and Other Novel Small Molecules
Tofacitinib (Xeljanz®) is the first oral medication approved by the FDA for the treatment of moderate to severe ulcerative colitis. A small molecule drug, Tofacitinib heralds the beginning of an exciting new class of oral medications for patients with ulcerative colitis. While as strong and effective as biologics, Tofacitinib doesn’t require injections or IV infusion like most biologics used to treat IBD. In addition to the convenience and ease of using Tofacitinib for treatment, it provides another option for patients who may not have responded well to conventional biologics.
This new medication represents a different mechanism of action than older biological agents. Tofacitinib is a selective inhibitor of janus kinase (JAK) enzymes. The JAK pathway is one of several novel pathways in the developing area of “oral” biologic and small molecule therapies to improve care for patients with IBD conditions.
At NorthShore, we are committed to advancing new therapies for a variety of gastrointestinal conditions. Clinical trials are now underway to investigate other oral therapies for the treatment of IBD to enhance patient outcomes and quality of life.
For More Information
To learn more about biological agents and small molecule drugs for IBD, or to schedule an appointment with an IBD physician, please call 847.570.2903.