IBD Treatments

There are a variety of medications and treatment options for inflammatory bowel disease. Some include:

 

Dexa Scan

A DEXA scan is a special test that checks how strong your bones are. It’s a non-invasive test, which means it doesn’t involve any needles or surgery. The main reason to have a DEXA scan is to find out if you have a condition called osteoporosis, which is when your bones are very weak and can easily break. The test uses x-rays to measure how much calcium and other minerals are in a part of your bone. There are a few reasons why you might need a DEXA scan. For example, if you’ve been taking a certain type of medicine called corticosteroids for a long time, or if you have a condition that can cause weak bones such as celiac disease or IBD. You can also be at higher risk if you have a family history of the disease or if you’re a woman who has gone through menopause.

  • Osteopenia is a condition that means your bones are weaker than normal, but not weak enough to break easily. The difference between osteopenia and a more serious condition called osteoporosis is the density of your bones. Osteopenia happens when your bones become brittle because they’re losing calcium. 
  • Osteoporosis is a disease that makes your bones very weak and brittle, so they can break easily from things like falls or even sneezing.  The most common places for osteoporosis-related fractures are the hip, wrist, and spine.

To keep your bones strong, it’s important to exercise and eat a healthy diet. Weight-bearing exercises, like walking or lifting weights, can help your bones stay strong. Aim for at least 30 minutes of these types of exercises every day. You should also get enough calcium and vitamin D, which help keep your bones healthy. Aim for at least 1,200 mg of calcium a day. Vitamin D is another essential ingredient to keep your bones strong. Most adults need 400-800 IU of vitamin D/day but in those that don’t get much sun, it is generally safe to take up to 4000 IU/day.

Cimzia

Cimzia is a biologic medication that is used to treat inflammatory diseases such as Crohn’s disease.  Cimzia is the brand name for certolizumab. It is a type of immunomodulator, which means that it modifies the immune system’s response.

Cimzia (certolizumab) works by binding to a protein called tumor necrosis factor (TNF), which is a key mediator of inflammation in the body. By binding to TNF, Cimzia blocks its activity and reduces inflammation in the affected tissues. This can help to alleviate the symptoms of Crohn’s disease and improve the patient’s quality of life.

Cimzia (certolizumab pegol) is an injectable medication, it is administered by subcutaneous injection. It is initially given once every two weeks.  Later doses are given every 4 weeks.  It can be self-administered or given by a healthcare provider. It is provided in a single-dose, pre-filled pen or pre-filled syringe, and it is important to follow the instructions provided by your healthcare provider and read the medication guide before using Cimzia.

The most common side effects of certolizumab are headaches, nausea, infection and fatigue.  Some patients will experience an injection reaction to the medication which most commonly happens just after getting the medication.  This may include itching, shortness of breath, chest pain, or rash.  If the reaction is mild, you may receive Tylenol, Benadryl or steroids to prevent these reactions in the future.  Most reactions can be prevented with these types of medications.

 

It also can have serious side-effects such as cancer and serious infections.

The risk of serious side effects is very low.  Before you start the medication, you will be checked for hepatitis B and tuberculosis (TB).  If you develop cough, fevers, or other signs of infection, you should contact your provider.  The risk of lymphoma, a type of blood cancer, is very rare at 4 in every 10,000 patients. 

 

It’s important to discuss with your doctor the potential benefits and risks of treatment with Cimzia (certolizumab) and any other medication. Your doctor will consider your individual circumstances and medical history, as well as the severity of your condition, when deciding whether or not to prescribe Cimzia. Your doctor will monitor you regularly while you’re on the treatment, and will order imaging test as needed.

 

It’s also important to report any symptoms that may be related to cancer, such as unexplained weight loss, night sweats, or lumps, to your healthcare provider right away.

Entyvio

Entyvio (vedolizumab) is a biologic medication used to treat inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease.

It is a monoclonal antibody that works by blocking a specific protein (alpha-4-beta-7 integrin) that plays a role in the migration of white blood cells to the gut, which is thought to contribute to the inflammation seen in these conditions.

Entyvio is administered via intravenous (IV) infusion, typically given every 8 weeks.  The first 3 doses are given more frequently.  It is important to follow the instructions provided by your healthcare provider and read the medication guide before using Entyvio.

The most common side effects of Entyvio (vedolizumab) include:  headache, nausea, fatigue, joint pain and upper respiratory tract infections (such as a cold or the flu).  Some patients may develop an infusion reaction to the medicine.  This is an allergic-type reaction, such as hives, trouble breathing, and swelling of the face, lips, tongue, or throat.  In most cases, your provider can given tylenol, benadryl and/or a steroid to control these symptoms.  

 

It’s important to talk to your doctor about any side effects you may experience while taking Entyvio. Your doctor may be able to help you manage them or suggest ways to prevent them.

Humira

Humira is a biologic medication that is used to treat inflammatory diseases such as Crohn’s disease and ulcerative colitis.  Humira is the brand name for adalimumab. It is a type of immunomodulator, which means that it modifies the immune system’s response.

Humira (adalimumab) works by binding to a protein called tumor necrosis factor (TNF), which is a key mediator of inflammation in the body. By binding to TNF, Humira blocks its activity and reduces inflammation in the affected tissues. This can help to alleviate the symptoms of Crohn’s disease and ulcerative colitis and improve the patient’s quality of life.

Humira (adalimumab) is administered by injection under the skin (subcutaneously) using a prefilled pen or a prefilled syringe. It can be self-administered or given by a healthcare provider. It is typically given once every two weeks. It is important to follow the instructions provided by your healthcare provider and read the medication guide before using Humira.

A biosimilar is a type of biological medicine that is highly similar to an existing biological medicine (referred to as the “reference product”). Biosimilars are designed to have the same safety and efficacy as the reference product, but they are typically less expensive.

 

Biological medicines, such as adalimumab, are made from living organisms and are typically more complex and expensive to produce than traditional chemical drugs. Biosimilars are developed using a different manufacturing process than the reference product, and may have slight differences in the way they are made.

 

To be approved for use, a biosimilar must go through a rigorous process of clinical trials and testing to demonstrate that it is highly similar to the reference product in terms of safety, efficacy, and quality. The regulatory authorities such as FDA will review the data to ensure the biosimilar has the same efficacy and safety profile as the reference product.

 

There will be several versions of adalimumab available starting in 2023.  Humira was the original version (the reference product).

Studies have shown it is safe for patients who are doing well on their biologic to switch to a biosimilar. This type of switching is typically required by your insurance provider. Talk to your provider if you have specific concerns.

The most common side effects of adalimumab are headaches, nausea, infection and fatigue.  Some patients will experience an injection reaction to the medication which most commonly happens while getting the medication.  This may include itching, shortness of breath, chest pain, or rash.  If the reaction is mild, you may receive Tylenol, Benadryl or steroids to prevent these reactions in the future.  Most reactions can be prevented with these types of medications.

 

It also can have serious side-effects such as cancer and serious infections.

The risk of serious side effects is very low.  Before you start the medication, you will be checked for hepatitis B and tuberculosis (TB).  If you develop cough, fevers, or other signs of infection, you should contact your provider.  The risk of lymphoma, a type of blood cancer, is very rare at 4 in every 10,000 patients. 

 

It’s important to discuss with your doctor the potential benefits and risks of treatment with Humira (adalimumab) and any other medication. Your doctor will consider your individual circumstances and medical history, as well as the severity of your condition, when deciding whether or not to prescribe adalimumab. Your doctor will monitor you regularly while you’re on the treatment, and will order imaging test as needed.

 

It’s also important to report any symptoms that may be related to cancer, such as unexplained weight loss, night sweats, or lumps, to your healthcare provider right away.

Infliximab

Infliximab is a biologic medication that is used to treat inflammatory diseases such as Crohn’s disease and ulcerative colitis. It is a type of immunomodulator, which means that it modifies the immune system’s response.

Infliximab works by binding to a protein called tumor necrosis factor (TNF), which is a key mediator of inflammation in the body. By binding to TNF, Infliximab blocks its activity and reduces inflammation in the affected tissues. This can help to alleviate the symptoms of Crohn’s disease and ulcerative colitis and improve the patient’s quality of life.

Infliximab is administered intravenously (through a vein) in a hospital or clinic. It is usually given as an infusion every 8 weeks, although the dosing schedule can vary depending on the individual patient and the severity of their disease.  The first 3 doses are given more frequently.

The most common side effects of infliximab are headaches, nausea, infection and fatigue.  Some patients will experience an infusion reaction to the medication which most commonly happens while getting the medication.  This may include itching, shortness of breath, chest pain, or rash.  If the reaction is mild, you may receive Tylenol, Benadryl or steroids to prevent these reactions in the future.  Most reactions can be prevented with these types of medications.

 

It also can have serious side-effects such as cancer and serious infections.

The risk of serious side effects is very low.  Before you start the medication, you will be checked for hepatitis B and tuberculosis (TB).  If you develop cough, fevers, or other signs of infection, you should contact your provider.  The risk of lymphoma, a type of blood cancer, is very rare at 4 in every 10,000 patients. 

 

It’s important to discuss with your doctor the potential benefits and risks of treatment with infliximab and any other medication. Your doctor will consider your individual circumstances and medical history, as well as the severity of your condition, when deciding whether or not to prescribe infliximab. Your doctor will monitor you regularly while you’re on the treatment, and will order imaging test as needed.

 

It’s also important to report any symptoms that may be related to cancer, such as unexplained weight loss, night sweats, or lumps, to your healthcare provider right away.

Remicade

Remicade is a biologic medication that is used to treat inflammatory diseases such as Crohn’s disease and ulcerative colitis.  It is the brand name of infliximab. It is a type of immunomodulator, which means that it modifies the immune system’s response.

Remicade works by binding to a protein called tumor necrosis factor (TNF), which is a key mediator of inflammation in the body. By binding to TNF, Remicade blocks its activity and reduces inflammation in the affected tissues. This can help to alleviate the symptoms of Crohn’s disease and ulcerative colitis and improve the patient’s quality of life.

Remicade is administered intravenously (through a vein) in a hospital or clinic. It is usually given as an infusion every 8 weeks, although the dosing schedule can vary depending on the individual patient and the severity of their disease.  The first 3 doses are given more frequently.

A biosimilar is a type of biological medicine that is highly similar to an existing biological medicine (referred to as the “reference product”). Biosimilars are designed to have the same safety and efficacy as the reference product, but they are typically less expensive.

 

Biological medicines, such as infliximab, are made from living organisms and are typically more complex and expensive to produce than traditional chemical drugs. Biosimilars are developed using a different manufacturing process than the reference product, and may have slight differences in the way they are made.

 

To be approved for use, a biosimilar must go through a rigorous process of clinical trials and testing to demonstrate that it is highly similar to the reference product in terms of safety, efficacy, and quality. The regulatory authorities such as FDA will review the data to ensure the biosimilar has the same efficacy and safety profile as the reference product.

 

There are several versions of infliximab available now.  Remicade was the original version (the reference product).  The biosimilar currently available in the United States include Inflectra, Renflexis, and Avsola.

Studies have shown it is safe for patients who are doing well on their biologic to switch to a biosimilar. This type of switching is typically required by your insurance provider. Talk to your provider if you have specific concerns.

The most common side effects of Remicade are headaches, nausea, infection and fatigue.  Some patients will experience an infusion reaction to the medication which most commonly happens while getting the medication.  This may include itching, shortness of breath, chest pain, or rash.  If the reaction is mild, you may receive Tylenol, Benadryl or steroids to prevent these reactions in the future.  Most reactions can be prevented with these types of medications.

 

It also can have serious side-effects such as cancer and serious infections.

The risk of serious side effects is very low.  Before you start the medication, you will be checked for hepatitis B and tuberculosis (TB).  If you develop cough, fevers, or other signs of infection, you should contact your provider.  The risk of lymphoma, a type of blood cancer, is very rare at 4 in every 10,000 patients. 

 

It’s important to discuss with your doctor the potential benefits and risks of treatment with Remicade and any other medication. Your doctor will consider your individual circumstances and medical history, as well as the severity of your condition, when deciding whether or not to prescribe Remicade. Your doctor will monitor you regularly while you’re on the treatment, and will order imaging test as needed.

 

It’s also important to report any symptoms that may be related to cancer, such as unexplained weight loss, night sweats, or lumps, to your healthcare provider right away.

Skyrizi

Skyrizi (risankizumab) is a biologic drug used to treat Crohn’s disease and psoriasis.

Skyrizi is a type of monoclonal antibody that works by targeting and blocking interleukin-23 (IL-23), a protein that plays a role in the development of Crohn’s disease. By blocking IL-23, Skyrizi helps to reduce inflammation and improve intesetinal symptoms in people with Crohn’s disease.

It is administered as a subcutaneous (under the skin) injection, usually once every 8 weeks. The first 3 doses are given after placing an IV in a hospital or clinic setting.  These IV doses are given every 4 weeks. The injections start 4 weeks after the 3rd IV dose.

Common side effects of Skyrizi include upper respiratory tract infections (cold, flu), headache, nausea, injection site reactions (pain, redness, itching) and fatigue. Serious side effects can also occur with Skyrizi, including allergic reactions,  infections (including tuberculosis and fungal infections), cancers and liver injury.  Liver injury is rare.  We will monitor your liver tests while taking this medication.  Most patients will not experience side effects with this medication.  

It is important to discuss the potential side effects of Skyrizi with your healthcare provider. They can provide more information on the risks and benefits of the drug, and help you make an informed decision about treatment.

Stelara

Stelara is a biologic drug.  It is also called ustekinumab.  It is approved to treat Crohn’s disease and ulcerative colitis.  It is also used for psoriasis.

Stelara (ustekinumab) is a biologic drug that works by targeting the interleukin-12 and interleukin-23 proteins. These proteins play a role in causing inflammation in diseases such as psoriasis and Crohn’s disease. Stelara blocks the activity of these proteins and helps to reduce inflammation and improve symptoms.

Stelara is administered by injection after a first intravenous dose. It is usually given every 8 weeks.

Common side effects of Stelara include upper respiratory tract infections (cold, flu), headache, fatigue, nausea and joint pain.  Serious side effects can also occur with Stelara, including: allergic reactions, infections (including tuberculosis and fungal infections), lymphoma and other cancers.  Longer studies have not found rates of cancer to be higher in Stelara users than the overall population.

 

It is important to discuss the potential side effects of Stelara with your healthcare provider. They can provide more information on the risks and benefits of the drug, and help you make an informed decision about treatment.