Crohn’s disease is a chronic inflammatory bowel condition that causes inflammation in the digestive tract. This inflammation can lead to abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition. Managing Crohn’s disease often involves various treatments aimed at reducing inflammation and achieving remission. Infliximab, a biological medication, helps control symptoms and improve the quality of life for many individuals.
Infliximab for Crohn’s Disease
Infliximab is a biologic medication classified as an anti-tumor necrosis factor-alpha (anti-TNF-alpha) agent. It is an antibody that targets and neutralizes TNF-alpha, a protein central to inflammation. By binding to both soluble and membrane-bound forms of TNF-alpha, infliximab prevents this protein from interacting with its receptors, disrupting the inflammatory cascade.
This targeted action reduces inflammation in Crohn’s disease, promoting healing of the intestinal lining. The decrease in inflammation can lead to a reduction in symptoms like abdominal pain and diarrhea, and can help achieve remission. Infliximab is prescribed for moderate to severe Crohn’s disease when other conventional therapies have not been effective.
The medication’s ability to block TNF-alpha also downregulates other pro-inflammatory cytokines, like interleukin-1 (IL-1) and interleukin-6 (IL-6), and reduces immune cell migration to inflamed areas. This anti-inflammatory effect contributes to gut lining healing.
Receiving Infliximab Treatment
Infliximab is administered intravenously (IV infusion) in a healthcare setting, such as a hospital or an infusion center. A healthcare professional places a needle in a vein to deliver the medication. Initial treatment involves an induction phase with three infusions given at week 0, week 2, and week 6.
Following the induction phase, patients transition to a maintenance schedule, receiving infusions every 8 weeks. Each infusion lasts at least two hours, though some rapid infusions can be as short as 30 minutes. During the infusion, healthcare providers monitor the patient’s vital signs, such as blood pressure, at regular intervals.
Patients are in a comfortable setting during the infusion, and the healthcare team may provide comfort measures. Pre-medications, such as acetaminophen or antihistamines, may be given before the infusion to prevent infusion-related reactions. After the infusion, patients are monitored for a short period to ensure no immediate adverse reactions.
Potential Considerations During Treatment
Patients receiving infliximab should be aware of potential considerations during treatment. Infusion reactions can occur during or shortly after the infusion. These reactions include fever, chills, itching, rash, changes in blood pressure, or difficulty breathing.
More serious, though less common, side effects include an increased risk of infections due to the medication’s effect on the immune system. These include bacterial, viral, or fungal infections, and reactivation of latent infections like tuberculosis or hepatitis B. Patients are screened for these conditions before starting treatment.
Regular monitoring is an important part of infliximab therapy, involving blood tests for blood counts or liver function. Patients are advised to report any new or worsening symptoms, including signs of infection like persistent fever, cough, or unusual fatigue, to their healthcare provider promptly. While on infliximab, avoiding live vaccines is recommended due to the altered immune response.