Biologics are the newest class of drugs that can relieve your Crohn’s symptoms and keep you in remission. As with all drugs, you need to weigh the risks and benefits.Because they suppress the immune system, all biologics carry an increased risk of infections, which in rare cases can be serious. Four biologics are approved by the FDA to treat Crohn’s:
- Cimzia (certolizumab)
- Humira (adalimumab)
- Remicade (infliximab)
- Tysabri (natalizumab)
People with tuberculosis, heart failure, or multiple sclerosis should not take biologics, because they can make those conditions worse.
Cimzia, Humira, and Remicade are a type of drug called a TNF inhibitor. In rare cases, some people taking TNF inhibitors have developed certain cancers such as lymphoma.Tysabri increases the risk of a very rare but potentially fatal brain infection called progressive multifocal leukoencephalopathy (PML). Tysabri also can cause allergic reactions and liver damage. It should not be used at the same time as other treatments that suppress the immune system or TNF inhibitors.
Most infections that occur with biologic use are far less serious Infections such as colds, upper respiratory tract infections, and urinary tract infections are common and don’t necessarily alter our treatment of Crohn’s.
Other common side effects from biologic use are generally temporary and include:
- Headache
- Flu-like symptoms
- Nausea
- Rash
- Injection site pain
- Infusion reactions
There are risks from conventional treatment too. While there are other treatments that suppress the immune system to treat Crohn’s, they too have side effects, Bloomfeld says. Like the biologics, drugs that suppress the immune system increase the risk of lymphomas and infections, which can be severe.
Corticosteroids like prednisone, for example, can cause a wide range of adverse effects, including:
- Weight gain
- Mood swings
- Bone loss
- Skin bruising
- High blood pressure
- High blood sugar
Those side effects are why corticosteroids may be used to control a flare, but aren’t the choice to treat Crohn’s over a long period of time. All effective therapies for Crohn’s disease come with some risk. It is not an option not to treat Crohn’s, so you need to weigh these risks against the benefits of having the disease well treated. You have to be willing to accept some risk to adequately treat Crohn’s disease.