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When to use Biologicals on Crohn’s disease

Biological therapies have become an important treatment option for individuals with Crohn’s colitis, a form of inflammatory bowel disease (IBD) that affects the colon. The use of biologicals is typically considered in cases where other treatments, such as corticosteroids or immunosuppressive medications, have not provided sufficient relief or due to the severity of the condition. Indications for biologicals in Crohn’s colitis may include

  1. Moderate to Severe Disease: Biologicals are often prescribed for patients with moderate to severe Crohn’s colitis who have not responded adequately to conventional treatments. This is characterized by symptoms such as frequent diarrhea, rectal bleeding, abdominal pain, and weight loss.
  2. Failure of Other Medications: When corticosteroids or immunosuppressive drugs fail to provide sustained remission or symptom relief, biologicals may be considered as an alternative treatment option.
  3. Steroid Dependency: If a patient with Crohn’s colitis is dependent on corticosteroids to manage symptoms, transitioning to biologicals can help reduce reliance on steroids, which are associated with various side effects.
  4. Perianal Disease: Biologicals may be recommended when perianal complications, such as abscesses, fistulas, or strictures, are present in addition to colonic inflammation.
  5. Maintenance of Remission: In some cases, biologicals are used as maintenance therapy to help prolong periods of disease remission and prevent relapses.
  6. Quality of Life Improvement: When Crohn’s colitis significantly impairs a patient’s quality of life, impacting their daily activities and well-being, biologicals may be considered to provide relief and enhance overall quality of life.
  7. Objective Signs of Inflammation: Evidence of ongoing inflammation in the colon, as confirmed by endoscopy, imaging studies, or laboratory markers, can be an indication for biological treatment.

It’s important to note that the decision to use biological therapies in Crohn’s colitis is highly individualized and should be made in consultation with a gastroenterologist or IBD specialist. Additionally, the specific choice of biological agent may depend on factors such as the patient’s medical history, response to previous treatments, and potential side effects. Biologicals for Crohn’s colitis often include drugs like anti-TNF agents (e.g., infliximab, adalimumab) and other targeted therapies (e.g., vedolizumab, ustekinumab).

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