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Allen KamravaMD · MBA · FACS · FASCRS

Medication

Biologic Therapy

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Back to work
2–12 weeks
Success rate
60–80%
Recurrence
10–30%

What it is

Biologic therapy involves the use of medications made from living organisms or their products to treat diseases. In the context of colorectal conditions, these therapies often target specific components of the immune system to reduce inflammation and control disease activity. Biologic therapies are typically used for moderate to severe inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, when other treatments have not been effective.

These medications can be administered through injection or infusion. They work by blocking certain proteins or cells that contribute to inflammation. Common types of biologic therapies include anti-TNF agents, vedolizumab, and ustekinumab. The choice of biologic therapy depends on the specific condition, its severity, and the patient's overall health.

Am I a candidate?

Biologic therapy may be recommended for patients who:

  • Have moderate to severe Crohn's disease or ulcerative colitis.
  • Have not responded adequately to conventional treatments like 5-ASA preparations, corticosteroids, or immunomodulators.
  • Are at high risk for colectomy.
  • Experience steroid dependency, resistance, or toxicity from other medications.

Recovery

Recovery and management following biologic therapy involve regular monitoring and adherence to the prescribed treatment plan.

Timeline and Expectations

The onset of symptom relief can vary, with some patients experiencing improvement within a few weeks, while others may take several months. Regular follow-up appointments are necessary to assess the medication's effectiveness and monitor for any side effects.

  • Patients should report any signs of infection, such as fever, cough, or skin rash, to their healthcare provider immediately.
  • Routine blood tests may be required to monitor liver function, blood cell counts, and drug levels.
  • It is important to continue taking other prescribed medications as directed, unless otherwise instructed by your doctor.

Risks & considerations

Potential risks associated with biologic therapy include:

  • Infusion Reactions: Some patients may experience reactions during or shortly after the infusion, such as fever, chills, rash, or difficulty breathing.
  • Infections: Biologic therapies can suppress the immune system, increasing the risk of infections, including serious infections like pneumonia or tuberculosis.
  • Antibody Formation: The body may develop antibodies against the biologic medication, reducing its effectiveness over time. Combination therapy with an immunomodulator may lower this risk.
  • Allergic Reactions: Allergic reactions to the medication are possible.
  • Increased Risk of Certain Cancers: There is a slightly increased risk of certain cancers, such as lymphoma, with some biologic therapies.

Sources

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