People can receive biologics via injection or intravenously. While they may reduce symptoms in some individuals, they also have potential side effects.
In this article, learn about the types of Crohn's infusions, as well as what to expect from this type of treatment.
Types of Crohn's infusions
A doctor administers biologic medications intravenously.
Biologics are medications that occur naturally. They are antibodies or immune compounds designed to target proteins in the body that may contribute to inflammation.
These medications can be beneficial for treating Crohn's disease because they target specific parts of the body. Other common medicines for Crohn's disease, such as corticosteroids, affect the whole body.
Doctors categorize these medications based on specific proteins they target. Not all biologics are available by infusion.
Examples of these medication types include:
- Anti-tumor necrosis factor: Also known as anti-TNF agents, these block a protein called tumor necrosis factor-alpha. They can help reduce Crohn's disease symptoms and heal intestinal inflammation. Examples of these medications include adalimumab (Humira), certolizumab pegol (Cimzia), and infliximab (Remicade).
- Integrin receptor antagonists: These drug types reduce the inflammatory compounds coming into the tissues from blood vessels. Infusions of these medications that are available for Crohn's disease include natalizumab (Tysabri) and vedolizumab (Entyvio).
- Anti-interleukin-12 and interleukin-23 therapy: A doctor may prescribe the medication ustekinumab (Stelara), which is a one-time infusion. A person will then give themselves injections every 8 weeks after the first infusion. The drug works by blocking proteins that contribute to inflammation.
Doctors do not usually prescribe biologics as an initial treatment for Crohn's disease, but they may recommend them if other treatments are not working.
How to prepare
A doctor will instruct a person on how to prepare for a Crohn's infusion. The procedure usually takes place in an outpatient treatment center or hospital.
However, some people may opt for receiving infusions at home, which is when a nurse comes to a person's home to give them the medication.
As there may be a risk of an allergic reaction, a doctor will usually recommend that a person has the first few infusions at a hospital or outpatient center.
A doctor will send a prescription to the infusion center with details about the type, dose, and length of the infusion.
A person may need to avoid eating or drinking before the procedure, but this is not always the case.
Since Crohn's infusions can take an hour or more, most centers recommend bringing reading materials or other items to help a person pass the time.
What to expect
The IV line usually goes into a vein in the arm.
While the procedure may vary slightly, people can usually expect the following when they have a Crohn's infusion:
- A nurse will start an intravenous (IV) line. This involves inserting a small, thin catheter into a vein, usually in the arm.
- The nurse will connect the medication to the IV. The medication is usually in an IV bag or bottle with a tube to connect to the IV in the person's arm.
- The infusion will begin. Because there is a chance for an allergic reaction, a nurse or doctor may start the infusion at a slightly lower concentration and increase it over time. A person should alert a nurse about any potential signs of an allergic reaction, such as trouble breathing, a rash, feeling nauseated, or a headache.
- The infusion will end. After the infusion is complete, a doctor may recommend the recipient has another person drive them home and monitor them in case an allergic reaction or side effects occur.
A person will not usually experience immediate positive effects after having a Crohn's infusion. It may take several weeks for an individual to notice their symptoms improving.
The length of time an infusion takes, and the frequency that a person must receive them, varies between different medications.
For example, the procedure for Remicade infusions lasts 2 to 4 hours. Doctors usually recommend receiving them every 2 weeks for 6 weeks. After that time, a person may go for infusions about every 6 to 8 weeks.
By comparison, the procedure for Entyvio infusions lasts for 30 minutes, and a person will receive further infusions after 2 weeks, 6 weeks, and then every 8 weeks after that.
Crohn's infusions can cause a range of side effects. Many of the effects are specific to the particular medication.
When receiving any medication intravenously, it is possible to have an allergic reaction or local reaction at the IV site.
For this reason, people should always ensure they are up-to-date with their immunizations before receiving infusions.
Other risks associated with Crohn's infusions and biologics include:
- altered liver functioning
- arthritis or joint pain
- a slightly increased cancer risk, including lymphoma, solid malignancy, and skin cancers
- a lupus-like reaction, which includes muscle aches, joint pain, a rash, and fever
A person should always discuss the risks specific to certain medication types. For example, receiving the Tysabri infusion increases the risks for a condition called progressive multifocal leukoencephalopathy (PML).
This condition occurs in people who have the John Cunningham virus, which does not usually cause any symptoms. As a result, doctors will test people for this virus before beginning Tysabri infusions.
Additional treatment options
A doctor may recommend combining different treatments.
Sometimes, a doctor will recommend Crohn's infusions alongside other therapies to increase the treatment's effectiveness.
An example of this is when a person takes an immunomodulator, which changes the body's immune system, and they also receive biologic infusions. This is known as combination therapy.
However, there are also greater risks for side effects when taking both medications.
Some of the risks can be serious. For example, if a person uses anti-TNF medications and immunosuppressants, such as azathioprine (Imuran), they are at greater risk for developing lymphoma.
Crohn's infusions are targeted treatments that can help Crohn's disease go into remission permanently.
A person should consider the potential benefits and side effects when taking this medication.
A doctor can speak to someone considering infusions about the possible effects based on their individual medical history, so they can make the most informed decision when managing their Crohn's disease.