In a single article outside of my usual pattern of writing a series, I wanted to focus more on the biologic drugs and medications offered to Crohn’s disease and ulcerative colitis patients, specifically the ones that I have tried personally. I’ll also be learning about and discussing the latest biologic, vedolizumab, known by the brand name Entyvio.
Entyvio is a new biologic that I will begin this Friday, just as this article posts, oddly enough.
As I mentioned in one of my previous articles, Crohn’s Disease Medications: Part Four in a Series, the medication treatment plan that doctors generally begin with is a pyramid-style plan, starting with medications that have the least number of side effects, or that are least harmful, at the bottom of the pyramid.
Some doctors use the same pyramid, but upside down, starting with the more aggressive medications first, but these also are potentially more harmful. While these medications may induce remission, other less dangerous medications may work for some patients, too.
Depending on the specifics of your individual disease and treatment progress, the location of your inflammation, related circumstances, and decisions made by you and your doctor, there are a plethora of medications to try.
Within this pyramid of treatment options, there are several medications some prefer to try before ever beginning biologic options, starting bottom up. These options can include steroids such as prednisone or budesonide, immunosuppressant medications like methotrexate and azathioprine, anti-inflammatory medications like sulfasalazine and mesalamine, and biologics like Humira (adalimumab) and Remicade (infliximab). I have tried almost all of these in my three-year journey to remission, so far. Most have been unsuccessful for me. We began at the bottom of the pyramid plan.
When those didn’t work for me, I found out I was allergic to sulfa drugs and I suffered several other side effects, like nausea and migraines. My doctor suggested a capsule endoscopy before and after the budesonide treatment to compare inflammation imaging. Once I had finished my trial of that medication, my results showed my Crohn’s had gotten worse.
I am still searching for remission; that’s why I have my first Entyvio infusion Friday.
Beyond these listed, some medications are targeted for other diseases and illnesses, like rheumatoid arthritis or psoriasis, and others target specific areas. Now a biologic medication has been created specifically for Crohn’s disease and ulcerative colitis patients.
Entyvio is a biologic drug meant for patients who have had no luck with other medications. According to its manufacturer, Entyvio can help some patients gain remission, improve the overall intestinal lining, and it can allow patients to stop taking steroids, like prednisone.
Like any medication, Entyvio comes with risks of infections because of our weakened immune systems, liver problems become a complication worry, and serious allergic reactions are always a concern. Side effects are somewhat a given, at least for me. I always seem to suffer from nausea, headaches, and rashes, with throat, back, joint, and overall body pain.
While other infusions can take hours, Entyvio averages about 30 minutes, a significant time drop from my Remicade days. And like other biologics, Entyvio requires a loading dose IV infusion of medications to get into your system.
Beginning week 0, with another dose at week 2, week 6, and then every eight weeks thereafter, like other biologics, Entyvio requires about six doses per year. According to the drug website, a portion of patients enter remission within six weeks to a year, fingers crossed for me.
I still take azathioprine, but I have never tried methotrexate, as it is not appropriate for women who are trying to conceive. It is important to watch kidney and liver panel tests, as these organs can be harmed when receiving these types of medications.
With Crohn’s medications, your doctors may suggest a different treatment plan from what I have tried. I cannot, and would not, offer medical advice, I can only share what I know from my personal experiences. Remember, my Crohn’s disease is individual for me, and what works for me may not necessarily work for you.
For me, It Could Be Worse.
Remember, Crohn’s disease and ulcerative colitis have no cure, and complications from them can worsen over time without remission.
Note: IBD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of IBD News Today, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to IBD.