Biologics (anti-TNF Drugs)
This information has been provided with kind permission from Crohn’s and Colitis UK - a nationwide charity committed to providing information and support, funding crucial research and working to improve healthcare services for anyone affected by Inflammatory Bowel Disease.
For further information please download the full patient publication from Crohn’s and Colitis UK
The two most commonly used biologics are:
• Infliximab (Remicade)
• Adalimumab (Humira).
Currently infliximab is most commonly used to treat severe active Crohn’s that has not responded to steroids or immunosuppressants. It may also be used to treat severe UC as an alternative to ciclosporin.
Not everyone responds to infliximab, but a number of studies have shown that it can be very effective at improving symptoms, bringing about remission and reducing the need for surgery.
Infliximab is given by intravenous infusion (a drip), over several hours, usually in hospital or a day clinic. If you respond well you will usually be prescribed a course of infusions. Your treatment should be reviewed at least every 12 months.
It is important to talk to your IBD specialist before you start infliximab about its possible benefits and risks, including the potential for side effects. You will also need to have a series of checks for pre-existing conditions such as tuberculosis (TB) as infliximab can reactivate this.
Side effects can include:
- reactions to the infusion
- greater susceptibility to infections
- a worsening of a pre-existing heart condition
- skin rashes
- joint inflammation
- more rarely, liver or nervous system problems
- an increased risk of some cancers including lymphoma (cancer of the lymph glands).
Adalimumab is a more recent synthetic (man-made) anti-TNF drug. It is mainly used for severe Crohn’s, although it is licensed to treat UC in some circumstances.
Adalimumab, like infliximab, has been shown to be effective at controlling flare-ups and at treating Crohn’s fistulas. It can also be useful when infliximab has failed. Adalimumab is injected subcutaneously (under the skin), so is easier to take at home.
A common side effect is pain at the injection site, sometimes with redness, itching and swelling. Other side effects are similar to those with infliximab and you will need similar checks and monitoring.
© Crohn’s and Colitis UK 2015