I've never experienced a biologic, so if anyone could explain the benefits in comparison to such drugs as azathioprine I'd be interested to know. It seemed my GI has high hopes for the drug.
There are generally three classes of ulcerative colitis medications. UC is an autoimmune disorder (or at least an immune deficiency) in which the immune system attacks the lining of our large intestine causing inflammation, diarrhea, pain, blood and mucus. Class one is topical anti-inflammatory medications with the active ingredient of mesalamine (examples asacol, lialda, pentasa, delzicol, rowasa, and canasa), they're generally well tolerated by most and few experience side effects.
From here on out, classes two and three are both medications that target our immune system, and slightly weakening our immune system.
Class two is immunomodulators (examples are Imuran/azathioprine or 6mp) these medications intentionally lower your body's white blood cell count. WBC are our bodies attach dog, directly causing inflammation. The less WBC you have, the less inflammation you have which improves our UC symptoms. These are very slow working medications that take multiple months to work. The downsides are you must have regular blood work while you remain on these medications (every three months), as your WBC cannot get too low. WBC has to stay within a certain safe range.
Class three are biologics (examples include Remicade, humira, simponi, and entyvio) which interfere with the immune system's ability to signal and initiate an attack on our large intestine. Remicade/infliximab is what's known as a TNF-alpha blocker. Your immune system creates a protein called TNF-alpha that essentially says "hey, send an attack over here" and WBC respond by attacking that area. Remicade is a bioengineered protein that is designed to dock with TNF-Alpha proteins. When one remicade protein docks with one tnf-alpha protein, the signal to attack is muted in that one instance. A typical infusion has numerous of these proteins and it enables you to mute or at least greatly silence your immune system's call to attack your intestine and you can heal as a consequence. Remicade requires no blood monitoring. Generally there are no side effects for the vast majority who take remicade. You might feel slightly sleepy afterwards, have a slight headache, etc. Usually the pre-medications prevent it.
Classes 2 and 3 are very similar with their safety profile. As they both slightly suppress your immune system, they carry the same increased rare but increased risk of infections requiring antibiotics becoming serious (UTI, bronchitis, bronchitis, etc) and a very small lymphoma risk (a 0.04 percent as compared to 0.02 for the general population).
Moderator Ulcerative Colitis
John, 38, in a minor flare, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/8wks; nightly rowasa; 15mgs predYou know you have UC if you take the dog for a walk and you both end up pooping within the bushes.