Beyond the Biologic: How Treatment for UC Really Works


If you have ulcerative colitis (UC), you’ve probably heard of biologics, a relatively new treatment for the condition.

While the goal of any drug therapy for UC is to help you achieve and maintain remission, 20 to 40 percentTrusted Source of people simply don’t respond to conventional UC medications, according to a 2015 study.

These drugs include:

  • aminosalicylates
  • steroids
  • immunosuppressive drugs

With all of the buzz around biologics, it can seem hard to sort out the key facts:

  • What are these drugs?
  • What do they do exactly?
  • Which biologic might be right for you?

Consider the following your roadmap to biologic success.

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 fight off the inflammation that causes so much discomfort for those living with UC.

Biologics are able to target specific areas in the body, making them even more effective. By contrast, steroids or other drugs treat the entire body and may have unwanted side effects.

Three types of biologics are:

  • anti-tumor necrosis factor (anti-TNF) agents
  • integrin receptor antagonists (IRAs)
  • interleukin (IL) inhibitors

Anti-TNF agents bind to and block the protein called tumor necrosis factor-alpha (TNF-alpha). In people with UC, this protein causes inflammation in the:

  • intestines
  • organs
  • tissues

Blocking this protein is important for UC remission. Anti-TNF agents have not only helped people maintain remission, but some can actually heal inflamed intestinal areas.

Anti-TNF agents for UC include:

  • Infliximab (Remicade). This drug is used to treat moderate to severe UC that hasn’t improved with other drugs or in people who can’t take other drugs. It comes as an infusion you get through a vein. The process takes 2 hours. You’ll get three doses over the first 6 weeks and then one dose every 8 weeks.
  • Golimumab (Simponi). This injectable medication is typically recommended for treating UC in people who are having trouble stopping the use of steroids. It can be administered at home or by your doctor. You usually receive two injections on your first day and one injection 2 weeks later. After the third injection, you’ll receive doses every 4 weeks.
  • Adalimumab (Humira). This prescription medication is injected into the abdomen or the thigh for the treatment of moderate to severe UC. After your doctor shows you how to use this drug, you can administer it at home every 2 weeks. Your doctor will check in with you at 8 weeks. If you haven’t achieved remission, you may need to stop this drug.

These medications block the protein on the surface of key inflammatory cells. This stops these cells from moving freely from the blood into body tissues.

Vedolizumab (Entyvio) is an IRA. This intravenous (IV) medication treats UC that hasn’t responded to any other UC treatments and in people who are trying to avoid taking steroids.

The infusion process takes about 30 minutes. You get three doses in the first 6 weeks of treatment, followed by one dose every 8 weeks.

This type of biologic targets proteins that are involved in the process that leads to inflammation.

Ustekinumab (Stelara), the newest biologic for UC, was approved by the Food and Drug Administration (FDA) in October 2019. It targets the proteins interleukin-12 and interleukin-23 in particular.

It’s recommended for treating moderate to severe UC in adults that hasn’t improved with other treatments.

The first dose is administered as an IV infusion at your doctor’s office or clinic, a process which takes at least an hour. You then get an injection every 8 weeks afterward.

You can perform the maintenance injections yourself, or your doctor can do them.

Keep in mind that biologics have possible side effects, such as:

  • headaches
  • nausea
  • fever
  • sore throat

Some more serious risks include decreased immune system function that can leave you susceptible to infections. You may also be more likely to experience:

  • lymphoma
  • liver problems
  • a worsening of heart conditions
  • arthritis

Talk with your doctor if you experience any side effects.

If you’re interested in trying a biologic, discuss all of the pros and cons with your doctor.

If you’ve already tried other drugs to treat your UC without any benefit, you might be a great candidate for a biologic.

JPeei Clinic

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