Ulcerative Colitis treatment methods have evolved considerably during the last 15 years. The latest treatment methods focus on drugs called Biologics.
Biologics come from natural sources like human and animal genes. However, they are also derived from microorganisms.
One of the salient features of microorganism-derived Biologics is their ability to act on the inflammation system parts that belong to the immune system.
According to Dr. Donald Tsynman, inflammation is the primary cause of inflammatory bowel diseases. It is the source of the major processes that contribute to diseases like Crohn’s disease, ulcerative colitis, etc. He emphasized that Biologics have proven to be very effective in treating such problems in certain patients.
The unique thing about biologics is their ability to target a person’s immune activity. Therefore, it distinguishes them from the other medications for treating ulcerative colitis.
Dr. Donald is a gastroenterologist from New York-Presbyterian Hospital, New York City. He and other experts on the subject shared some interesting insights about biologics and their impact on the immune system.
Everyday Health summarizes these insights in a recent article, helping us understand the good and bad related to biologics.
Biologics Target Proteins Involved in Inflammation
According to Dr. Joel Pekow, an associate professor of medicine at the University of Chicago, the biologics approved to treat ulcerative colitis and Crohn’s disease target proteins involved in inflammation. They constitute the list of FDA-approved biologics for treating ulcerative colitis. These biologics include:
- Simponi (Golimumab)
- Stelara (ustekinumab)
- Remicade (infliximab)
- Humira (adalimumab)
- Entyvio (vedolizumab)
Most of these biologics target tumor necrosis alpha (TNF-alpha), a protein that promotes inflammation in the body. However, Biologics also works against inflammation by dealing with too many white cells. Generally, abundant white cells can accumulate in the gastrointestinal tract during inflammation.
Entyvio blocks the White Blood cells from reaching the inflammation site and hence eliminates the chances of inflammation.
Research Evidence Proves Biologics as Effective Remedy for Ulcerative Colitis
The United European Gastroenterology Journal published a review in 2019 after examining the efficacy and safety of certain biologics to treat ulcerative colitis. These biologics included Simponi, Humira, Remicade, and Entyvio.
The research concluded that these biologics were found effective in treating severe and moderate ulcerative colitis. Moreover, there were no serious side effects, so the researchers termed the drugs safe for treatment.
Stelara, the New Kid on the Block
Stelara was approved recently in 2019 after it proved its worth in treating Crohn’s disease. Even though the drug has been on the market since 2009, its approval came after the researchers found effective results in treating psoriatic arthritis, psoriasis, and Crohn’s disease. As a result, it was approved for treating ulcerative colitis two years ago.
The approval for Stelara was also forced by a clinical trial that was published in September 2019. The New England Journal of Medicine published the research concluding that Stelara is safe and effective in maintaining remission with ulcerative colitis. In addition, it was found safe for both moderate and severe levels of illnesses.
As compared to other biologics, Stelara is a relatively new biologic. It blocks the interleukin-13 and -23. These proteins can hinder the immune response and contribute to bowel disease and immune-related conditions.
Pros and Cons of Biologics for Ulcerative Colitis
Ulcerative Colitis treatment through biologics seems to be the way forward. However, every treatment comes with its set of pros and cons. Biologics are no exception. Therefore, it is critical to understand their benefits and demerits.
Let’s find out more.
The Upside of Biologics for Ulcerative Colitis
There are several advantages of biologics for ulcerative colitis. Here is a quick discussion:
Improvement of Gut Symptoms
Biologics have been found to improve the gut symptoms in the body. They can help maintain remissions for patients with moderate to severe ulcerative colitis. Also, biologics prevent the need for hospitalization to a great extent. According to the Crohn’s & Colitis UK, biologics can help avoid surgeries too.
Efficient Remedial Action
Biologics have quite an efficient mechanism of targeting ulcerative colitis problems. According to the Crohn’s & Colitis Foundation, it’s a major advantage of biologics compared to other treatment methods. For instance, corticosteroid treatment can trigger side effects which affect the whole body.
On the other hand, biologics are more selective in their approach. They only target specific proteins responsible for the problem, so the body’s overall balance doesn’t have to suffer a great deal.
The Possible Downsides of Biologics
Biologics have more benefits than disadvantages. However, there are certain limitations to their use. Here is a quick look:
Not Suitable for All
Dr. Laura Raffals is a gastroenterologist at Mayo Clinic, Rochester in Minnesota. She believes that biologics may not suit every patient with ulcerative colitis. Therefore, it is important to work with the patient to devise an effective strategy for the treatment.
Hence, it may involve practices like small-molecule drug provision and different biologics while keeping in mind the patient’s insurance cost.
Need for More Long Term Data
Even though the research studies have shown promising results, there is a need for more research to validate biologics. In addition, since they are relatively new drugs, the long-term unavailability of data is a major hindrance for these drugs.
Biologics Can Be Costly
Biologics are generally quite expensive because they come from some of the top brands in the pharmacy world. However, the introduction of biosimilars, agents very similar to biologics, has helped reduce the price of biologics to a certain extent.
Complex Treatment Methods
Biologics tend to have a complicated treatment process. It’s not as simple as swallowing a pill. They may be injected, while some of them require intravenous infusion. The treatment methods, therefore, also depend on your comfort level with a certain method.
Side Effects
Biologics can induce side effects like fever, aches, pain, and soreness at the injection sites. They also increase the possibility of infection.
Conclusion
Biologic treatments are relatively new, especially for ulcerative colitis. According to Dr. Raffals, there is a need to educate patients as they might be scared to try the new treatment methods.
According to studies, the biological treatment for ulcerative colitis is quite safe, and it’s only a matter of time before it becomes a common thing.
