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Beyond the Biologic: How Treatment for UC Really Works

Medically reviewed by Saurabh Sethi, MD, MPH on February 8, 2018Written by Melissa Carroll, PhD on February 8, 2018
beyond the biologic

If you have ulcerative colitis (UC), you’ve probably heard of biologics, a relatively new treatment for the condition. While the goal for any UC drug therapy is to help you achieve and maintain remission, of people simply don’t respond to conventional UC medications such as aminosalicylates, steroids, and immunosuppressive drugs.

With all of the buzz around biologics, it can seem hard to sort out the key facts. What are they? What do they do exactly? Which biologic might be right for you?

Consider the following your road map to biologic success.

What are biologics and how do they work?

Biologics are made out of antibodies that are grown in a laboratory. The natural properties of biologics are able to stop certain problem proteins in the body from causing inflammation.

Think about biologics as tiny, human-made soldiers. When they’re injected into the body, they do our bidding, fighting off the inflammation that causes so much discomfort for those living with UC. Making them even more enticing, biologics are able to target specific areas in the body, unlike steroids or other drugs that treat the entire body and may have unwanted side effects.

Two popular types of biologics include:

  • anti-tumor necrosis factor agents (anti-TNFs)
  • integrin receptor antagonists (IRAs)

Anti-TNFs

Anti-TNFs bind onto and block the protein called tumor necrosis factor-alpha (TNF-alpha). This protein causes inflammation in the intestines, organs, and tissues of people with UC problems. Blocking its development is important for UC remission. Anti-TNFs have not only helped people maintain remission, but some can actually heal inflamed intestinal areas.

Some anti-TNFs include:

  • Adalimumab (Humira). This prescription medication is injected into the abdomen or the thigh for those with moderate to severe UC. After your doctor shows you how to use this drug, you can administer it at home. Injections are performed biweekly.
  • Certolizumab pegol (Cimzia). This injectable medication has been successful in helping those with UC maintain remission. The injection is administered by either your doctor or yourself. If it works well for you, it’s usually administered every four weeks.
  • Golimumab (Simponi). This medication is typically recommended to people who are having difficulty coming off of steroidal treatments for UC. This is also an injectable medication that can be administered at home or by your doctor, and is usually given monthly.

IRAs

These medications block the protein on the surface of key cells that cause inflammation, stopping these cells from moving freely into body tissue.

Some examples of IRAs include:

  • Natalizumab (Tysabri). This is an infusion that can only be injected by a healthcare professional at a certified infusion treatment center. It’s used on people whose other UC treatments have failed them. The injection takes about an hour.
  • Vedolizumab (Entyvio). Similar to Natalizumab, this intravenous medication is used to treat people who haven’t been responsive to any other UC treatments and are trying to stay off of steroids. The infusion process for this drug takes about 30 minutes.

What you should know before trying a biologic

For the most part, biologics are only introduced as an option for treating UC when the first course of treatments have been exhausted.

Keep in mind the potential side effects associated with biologics such as headaches, nausea, fever, and sore throat. Some more serious risks include a reduced immune system that can leave you susceptible to infections, and a higher susceptibility to develop lymphoma, liver issues, worsening heart conditions, and arthritis. Talk to your doctor if you experience any side effects.

The takeaway

If you’re interested in trying a biologic, discuss all of the pros and cons of biologics for you and your particular case of UC with your doctor. In some instances, you might have tried everything else without any benefit. This makes you a great candidate for a biologic.

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