The Advantages Of Biologics For Ulcerative Colitis
Biologics can improve gut symptoms, bringing about and maintaining remission in people with moderate to severe ulcerative colitis. They can also reduce the need for hospitalization and surgery, says the British organization Crohn’s & Colitis UK.
One key advantage of biologic therapies over other types of treatment for ulcerative colitis is that their mechanisms of action are more precisely targeted to the factors responsible for the condition, notes the Crohns & Colitis Foundation.
Unlike corticosteroids, for example, which affect the whole body and may produce major side effects, biologic agents act more selectively. These therapies are targeted to particular proteins that have already been proven to be involved in ulcerative colitis.
Patients are often nervous about biologics, says Laura Raffals, MD, a gastroenterologist at the Mayo Clinic in Rochester, Minnesota. But theyre not as scared about taking a corticosteroid, and thats an important conversation to have because the data shows that patients on biologics are much safer and stay in remission longer. The serious side effects we see are from steroids or narcotics, not biologics.
Infusions Every 8 Weeks After 3 Starter Doses
REMICADEÂ® is given as an intravenous infusion by a healthcare professional through a needle placed in a vein in your arm.
Given over a period of about 2 hours
Weeks 0, 2, and 6
After starter doses, 1 maintenance dose is infused every 8 weeks
Your doctor will determine the right dosage of REMICADEÂ® for you. If you lose response to REMICADEÂ® at 5 mg/kg, your doctor may consider increasing your dosage to 10 mg/kg every 8 weeks. If you don’t respond by Week 14, your doctor should discuss discontinuing REMICADEÂ®.
Which Coronavirus Vaccine Will I Be Offered
The COVID-19 vaccines currently approved for use in the UK are:
- Moderna vaccine
- Pfizer/BioNTech vaccine
All of the available coronavirus vaccines are considered suitable for people with Crohn’s or Colitis, as they are not live vaccines. Having Crohn’s or Colitis, or taking medicine to treat your condition, will not affect which coronavirus vaccine is best for you.
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Will My Body Make Antibodies To Remicade
Yes, its possible for your body to make antibodies to Remicade. This would affect how well the medication works.
Since Remicade is a biologic medication, your body could identify it as a foreign substance. Your body may then try to remove the drug by making antibodies. If this happens, your doctor may need to switch your medication.
Some people may have a higher risk for making antibodies to Remicade, such as those with Crohns disease.
Taking other immunosuppressants with Remicade may lower the risk of your body making antibodies against Remicade. If youre concerned about producing antibodies to this drug, talk with your doctor.
Important Safety Informationabout Entyvio
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call .
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Will The Vaccine Cause My Crohn’s Or Colitis To Flare
We are aware of some people with Crohns or Colitis reporting that they had a flare up after getting the COVID-19 vaccine. At this stage, there is no evidence that the vaccines can cause a flare up of Crohns or Colitis or make an existing flare worse. We are observing the data very closely and will update our information accordingly.
Some common side effects of the vaccine include feeling sick , fatigue, vomiting and diarrhoea. It may be that if you are experiencing these, it is a temporary side effect rather than the start of a Crohn’s or Colitis flare-up.
If you feel you have had a side effect from the COVID-19 vaccine, you can report it via the MHRA Yellow Card reporting site, and speak to your IBD Team.
In their official statement on the coronavirus vaccine the British Society of Gastroenterology states:
No serious gastrointestinal side-effects to SARS-CoV2 vaccinations have yet been reported. Furthermore, data from other commonly employed vaccination programs are reassuring, with no serious gastroenterological side effects and low rates of increased IBD disease activity reported.
When weighing up the risk of side effects of the vaccine, it’s also important to also consider the risks of complications from COVID-19 if you were to catch the virus. Complications from the virus can be life-threatening, especially if you are at increased risk. Research has shown the vaccines help reduce your risk of getting seriously ill or dying from COVID-19.
Intensification Of Dosing Frequency
Overall, WKM rates of dosing frequency intensification were significantly lower for the vedolizumab cohort compared with the infliximab cohort at 12 months and at 24 months after the initiation of the maintenance phase .
Weighted KaplanMeier curves of dosing frequency intensification in IBD patients . *Statistically significant at the 5% level. Dose escalation via increased dose is not included in this end point. Only dose escalation via intensification of dosing frequency is included.
WKM rates of dosing frequency intensification were significantly lower in patients with UC who received vedolizumab at 12 months and 24 months after the initiation of the maintenance phase relative to patients who received infliximab. Similar results were found in patients with CD at 12 months and at 24 months after the initiation of the maintenance phase .
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Can Children And Young People Have The Vaccine
The JCVI are a group of experts that advise the government on vaccines. This group, along with Chief Medical Officers, have been looking at the benefits and effects of young people receiving the vaccine.
In England, Wales, Northern Ireland and Scotland, all children aged 12 to 15 years will be offered the Pfizer COVID-19 vaccine. The vaccine is not mandatory and parents or guardians will be asked to give consent before their child receives the vaccine.
In England, the vaccine is likely to be given as part of the school vaccination programme. For more information, visit the GOV.UK website. For young adults aged 16 to 18 years, they can attend a walk in centre for their vaccination.
In Scotland, all children and young people aged 12 to 17 years should receive an appointment letter inviting them to an appointment at a drop-in centre or vaccination clinic. For more information, visit the NHS Inform Scotland website.
In Wales, some areas will invite this age group to vaccination centres and other areas will offer the vaccine through the school vaccination programme. For more information, visit the Welsh Government website.
In Northern Ireland, the vaccine is likely to be given as part of the school vaccination programme. For more information, visit the Northern Ireland Department of Health website. Young people aged 16 to 18 years can book an appointment or find a mobile clinic here.
Key Points About Remicade
- Remicade is given by IV.
- Remicade is approved for Crohn’s disease and ulcerative colitis.
- Three starting doses are given .
- After the starting doses, it’s given about every eight weeks .
- Common side effects are abdominal pain, nausea, fatigue, and vomiting.
- If you are pregnant or plan to become pregnant, you and your doctor should decide if you should take Remicade.
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Talking About The Effectiveness Of Medicines
To see how effective a medicine is, we can look at data from clinical trials. Clinical trials are used to test a medicine. However, this data may not completely represent what happens when medicines are given to you by your IBD team. In clinical trials, people are often removed from the trial if they do not respond quickly to a medicine. This wont happen when you start taking infliximab. Your IBD team may advise you take it for a longer time to see if you respond. Theyll also make sure the dose is right for you before suggesting you stop taking it. This means infliximab may be more effective than the data from clinical trials shows.
The best clinical trials include people who were not taking the medicine. This is known as a placebo or control group. This is important. It allows us to see how many people have got better because of the medicine, as well as people who may have got better anyway .
Astrazeneca Vaccine In People Under 40
The JCVI has advised that it is preferable for people under 40 to have a vaccine other than AstraZeneca. This is due to a possible, very rare, risk of blood clots The risk of blood clots is extremely rare just over 10 people develop this condition for every million doses of AstraZeneca vaccine given.
If you have concerns or are unsure about whether to have the AstraZeneca vaccine, contact your medical team for advice. When weighing up the risks and benefits, you should also consider that clotting problems are a common complication of COVID-19 infection. Deep vein thrombosis , or clotting in the legs, occurs in 11.2% of people who have COVID-19. Pulmonary embolism, or clotting on the lungs, occurs in 7.8% of people who have COVID-19.
Not everyone with Crohn’s or Colitis is at higher risk of severe illness from coronavirus – check your risk.
Does my Crohn’s or Colitis increase my risk of blood clots?Crohn’s and Colitis are not blood clotting disorders. However, they may slightly increase your risk of blood clots. You’re more at risk during a flare-up or if you’re confined to bed, for example in hospital. You can reduce your risk by not smoking, keeping active, drinking plenty of fluids, and wearing support stockings.
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Key Points About Stelara
- Stelara is approved to treat Crohn’s disease.
- The loading dose of Stelara is given by infusion and thereafter is given by injections at home.
- People taking shots for allergies should talk to their doctor about possible allergic reactions and Stelara.
- Common side effects include infections, injection site reactions, and vomiting.
- If you are pregnant or plan to become pregnant, you and your doctor should decide if you should take Stelara.
- It’s thought that Stelara does pass into breastmilk.
- Stelara must be refrigerated.
Receiving Remicade With Other Drugs
If you have RA, your doctor can only prescribe Remicade with methotrexate.
Flare-ups of inflammatory diseases may require taking corticosteroids.
People using Remicade with methotrexate or corticosteroids have a higher risk for developing a serious infection. This is because Remicade, methotrexate, and corticosteroids are all immunosuppressants. They reduce the activity of the immune system, decreasing the ability of your body to fight infections.
Other medications you may need to take with Remicade include:
- aminosalicylates, including mesalamine and sulfasalazine
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Can People With Crohn’s Or Colitis Have The Covid
Having Crohn’s or Colitis, or taking any medicine to treat your condition, will not stop you from being able to have the COVID-19 vaccine. All of the available vaccines are suitable for people taking biologics, steroids or immunosuppressants, as well as people who have a stoma or J-pouch.
As with any medicine or vaccine, there is a small risk of side effects, which you can find out more about on the NHS website. There is no evidence to suggest that having Crohn’s or Colitis, or taking any medicine to treat your condition, increases your risk of side effects. When weighing up the risk of side effects of the vaccine, it’s also important to also consider the risks of complications from COVID-19 if you were to catch the virus.
If you feel you have had a side effect from the COVID-19 vaccine, you can report it via the MHRA Yellow Card reporting site.
As is the case with other vaccines, no coronavirus vaccine will be 100% effective for everyone, and there is no guarantee that it will give complete protection. To compare, flu jabs are around 50% effective on average for the general population, yet are still effective in reducing the amount of hospitalisations and serious complications from flu. If you do catch COVID-19 after being vaccinated, it is likely that the virus will be less severe and you will recover faster than if you had not had the vaccine.
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What Are Biologics For Ulcerative Colitis
Biologics are medications that doctors use to treat chronic inflammatory conditions such as inflammatory bowel disease . Ulcerative colitis is one type of IBD.
These laboratory-made antibodies are targeted to block specific proteins responsible for the inflammation that drives ulcerative colitis. This makes biologics different from medications such as corticosteroids, which may cause more severe side effects.
The Food and Drug Administration has approved the following biologics to treat moderate-to-severe ulcerative colitis:
- anti-tumor necrosis factor agents, including:
The FDA approved the biosimilars of infliximab and adalimumab. As their name suggests, biosimilars are very similar to the originally approved biologics but may be more cost effective.
A person may receive biologics as an injection, as an infusion through an intravenous line, or by mouth.
The method of use, dosage, and frequency varies from one type of biologic to another.
Doctors typically prescribe an anti-TNF agent before they prescribe other types of biologics for moderate-to-severe ulcerative colitis. This is because anti-TNF medications are the most studied treatments.
Doctors may prescribe another type of biologic or a JAK inhibitor if the anti-TNF agent:
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What Should I Know About Remicade Vs Stelara
Your doctor may prescribe either Stelara or Remicade if youre an adult and have any of the following conditions:
But doctors may also prescribe Stelara for some children with plaque psoriasis. Some children may also receive Remicade for ulcerative colitis and Crohns disease.
While both Remicade and Stelara can treat the same diseases, they work on different parts of the immune system.
Stelara blocks immune factors called interleukin-12 and interleukin-23. These immune factors may also play a role in certain autoimmune diseases. These are diseases that cause your immune system to attack your own body. Remicade works by blocking the activity of a type of immune system protein called tumor necrosis factor.
To learn more about these drugs and find out which might be best for you, talk with your doctor.
Data Collection And Variable Definitions
Data was collected through ambidirectional review of electronic medical records and laboratory results. Factors collected at the time of the first observation in our tertiary center included age, race, gender, duration of UC, disease extent of UC, nicotine use, PPI use, and vitamin D level. Nicotine use was defined as actively smoking at the first observation, PPI use was defined as PPI use at the first observation, and vitamin D was defined as adequate if 25-OH vitamin D level was over 30 ng/mL and inadequate if under 30 ng/mL.
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Are There Any Reviews Available From People Whove Used Entyvio
The manufacturer of Entyvio provides some reviews from people whove taken this drug. You can find those reviews here.
You can also ask your doctor for more information about their experience with Entyvio and how other people theyve cared for have responded to the drug. Your doctor can also tell you about studies of people whove taken Entyvio.
How Long Does Entyvio Take To Work
Treatment with Entyvio is broken into two parts. The first three starting doses are given during the induction phase, which lasts a total of six weeks. During this phase, the second dose is given two weeks after the first dose. The third dose is given four weeks after the second dose.
Although symptoms may begin to improve right away after the first infusion, it may take the full six-week period to get symptoms under control.
The maintenance phase follows the induction phase. During the maintenance phase, doses are given every eight weeks to keep symptoms under control.
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What Should I Know About Entyvio Vs Remicade
Entyvio and Remicade are both used to manage symptoms of inflammatory bowel disease. Specifically, theyre both used for Crohns disease and ulcerative colitis. Remicade is also used to manage other autoimmune conditions.
Talk with your doctor if you have more questions about Entyvio versus Remicade. You can also check out this detailed breakdown of the two medications.
Humira has the active ingredient adalimumab, and Entyvio has the active ingredient vedolizumab.
Humira is given as an injection under the skin. You can give the drug to yourself at home.
Entyvio, on the other hand, is given at a doctors office or clinic. Its given by intravenous infusion, which is an injection thats given slowly into your vein.
If youd like to know about the similarities and differences of Entyvio and Humira, see this comparison. And talk with your doctor about which drug is right for you.
Specifically, Entyvio is used in adults to treat moderate to severe: