WHAT ARE BIOLOGIC MEDICINES?

Your doctor or a friend may have talked about "biologics" as a treatment for IBD. Wouldn't be a surprise, since these powerful medicines have one of the most important changes that can be offered to patients now. But what are they?

Typically, medicines are created and then manufactured by combining or changing chemicals into a new molecule that can be used as a drug. That drug can be looked at in different ways to analyze its structure. You can compare those molecules to salt or sugar, for example. Scientists can draw every element and test the exact structure and make sure it always the same.

A biologic is much larger and more complex, because it is actually a combination of molecules. And the only way to make them is to use plant or animal cells do the manufacturing. Sounds strange.

A Simple Comparison

But think of a probiotic, where you take a bacteria or yeast to benefit your body. With a biologic, scientists can insert a small piece of DNA (the building block of genes) into a virus or other microbe so that it can create these complex molecules. The scientists then harvest these biologic molecules and use them as medicines. The scientists and manufacturers have to do very careful testing to make sure the biologics are effective and not harmful, because small differences in the process can make a big change in how the medicine works.

Some of the first biologics, anti-TNFs, were developed to combat rheumatoid arthritis and its joint inflammation. These medicines were quickly found to have an effect on other autoimmune disorders like inflammatory bowel disease (IBD) and psoriasis. However, the dose used and how often it is used vary for each condition.

Newer biologics used for IBD also lessen the inflammation that is caused when the immune system attacks tissues in the body. But they attack different targets because not all patients with Crohn's disease, ulcerative colitis and other immune disorders over-produce TNF as the cause of their disease and symptoms.

Since each medicine has particular features, each one is discussed separately:

Anti-TNFs

• Adalimumab (Humira)
• Certolizumab (Cimzia) 
• Golimumab (Simponi)
• Infliximab (Remicade)
• Biosimilars 

Ustekinumab (Stelara)

Vedolizumab (Entyvio)