Crohn’s infusions, also known as biologics, are a class of drugs that can alleviate the symptoms of the disease and ideally, keep it in remission.
Crohn’s disease, an inflammatory bowel disease, triggers inflammation of the digestive tract. This, in turn, can lead to severe symptoms, including abdominal pain, fatigue, persistent diarrhea, weight loss, and malnutrition. While there is no cure for the disease, there are several treatments available that can help to manage symptoms - one of them being Crohn’s infusions.
Crohn’s infusions, also known as biologics, are a class of drugs that can alleviate the symptoms of the disease and ideally, keep it in remission. Individuals can receive Crohn’s infusions via injection or intravenous route administration. However, due to the fact that they suppress the immune system, all Crohn’s infusions carry an increased risk of infections, including the hepatitis B virus and tuberculosis. If an individual taking an infusion develops a severe infection, the drug should be discontinued. Having said that, individuals should always ensure they are up to date with their vaccinations before receiving these drugs. Moreover, individuals with multiple sclerosis, heart failure or tuberculosis should not take Crohn’s infusions because they can aggravate their conditions.
Key area of focus in IBD research
Crohn’s infusions can be helpful with treating Crohn’s because they target specific areas of the body. Doctors categorize these biologic drugs based on the specific proteins they target and not all of them are available via infusion. Examples of these drug types include the following:
- Anti-tumor necrosis factor – Also known as anti-TNF agents, these drugs block a protein called tumor necrosis factor-alpha – the protein responsible for triggering inflammation. As a result, they can help alleviate the symptoms of Crohn’s disease and heal intestinal inflammation. Examples of these drugs include: Humira (adalimumab), Cimzia (certolizumab), and Remicade (infliximab).
- Anti-interleukin-12 and interleukin-23 therapy – A doctor may prescribe the drug Stelara (ustekinumab), which is a one-time infusion that works by hindering the action of the inflammatory agents’ interleukin-12 and interleukin-23. After the first infusion, an individual will then give themselves injections every 2 months.
- Integrin receptor antagonists – These drugs block certain immune system processes that promote inflammation and cause damage to the intestines. They are given via injection and examples available for Crohn’s disease include: Tysabri (natalizumab) and Entyvio (vedolizumab).
While not all doctors share the same opinion on when to start Crohn’s infusions for Crohn’s disease, they do agree that these biologic drugs should be taken when individuals have severe disease that can lead to permanent damage that may require surgery. Crohn’s infusions are not usually prescribed as an initial treatment for Crohn’ disease, but they may be recommended if other treatments have proven to be ineffective.
According to Prabhakar Swaroop, assistant professor and director of the inflammatory bowel disease program at the University of Texas Southwestern Medical Center, it is necessary to look for signs that Crohn’s disease is advancing, such as how long between an individual’s diagnosis and the onset of fistulas. “These are the patients who generally do better on biologics, who have the quality of life improvement, who are able to avoid surgery and get back in the workforce” he said.
It is equally important to check for potential problems before prescribing Crohn’s infusions. “In the beginning, of course, we go ahead and make sure the person does not have an active liver infection or TB” said Marie Borum, a professor of medicine and director of the division of gastroenterology and liver diseases at George Washington University. Once an individual is started on an infusion, the doctor monitors for potential side effects in order to find them before they have the chance to cause more severe damage.
While the procedure may vary slightly, individuals can usually expect the following when they have a Crohn’s infusion:
- A nurse will set up the IV, which involves inserting a small thin catheter into a vein. This is normally done in the arm.
- The nurse will then connect the infusion, which is usually in an IV bag or bottle, to the IV line in the individual’s arm.
- The nurse may start the infusion at a slightly lower concentration and increase it over time to catch any immediate signs of an allergic reaction. Possible signs of an allergic reaction, such as a rash, difficulty breathing, nausea or headache, should be reported right away.
- After the infusion is complete, a doctor may recommend that the recipient has another individual drive them home and monitor their well-being in case of an allergic reaction or the onset of side effects.
- The length of time a Crohn’s infusion takes and the frequency that an individual must receive them depends on the specific biologic drug in question. For instance, the procedure for Remicade infusions lasts 2-4 hours and it is recommended to receive them every 2 weeks for a period of 6 weeks. The procedure for Entyvio infusions, on the other hand, lasts for half an hour and it is recommended to receive them following 2 weeks, 6 weeks, and then every 8 weeks after that.
Generally, an individual will not experience immediate positive effects after having a Crohn’s infusion.
To sum up, knowing what to expect can make switching to Crohn’s infusions easier. Remember that:
- Crohn’s infusions cannot be taken via oral route administration because stomach acids will destroy the delicate complexity of these drugs.
- Crohn’s infusions can trigger wide range of side effects, such as itching, bruising, swelling, redness, pain, fever, headache, chills, and hives.
- Crohn’s infusions come with risks, including infection, cancer, liver function changes, arthritis, and lupus-like reaction.
- Once started, Crohn’s infusions will likely have to be continued in use, even in remission. There are, however, certain instances when a doctor may instruct taking a break, such as before surgery.
- Taking/going off Crohn’s infusions during pregnancy needs to be discussed with a doctor, as the long-term effects on infants exposed to these drugs during pregnancy remain unknown. It may be appropriate to take a break halfway through pregnancy depending on the type of infusion in question.
Above all, Crohn’s infusions work by targeting and suppressing the inflammation response that can trigger Crohn’s flares. However, as with all types of drugs, it is important to weigh the risks and benefits. Crohn’s infusions come with potential side effects, such as reduced ability to fight infection. This is why consultation with a doctor is of utmost important. With their help, an individual can make an informed decision about whether to start treatment with these biologic drugs.