Targeted treatments for Crohn's explained.

If you have moderate to severe Crohn's disease your doctor may suggest potential treatment options such as biologics or targeted oral small molecules. Here’s an overview of how these treatments work and how they differ from each other. Discuss them with your doctor to see if one could be right for you.

On this page, you'll find info about:

Biologics & targeted oral small molecules

Types of biologics

Types of targeted oral small molecules

Biologics & targeted oral small molecules.
What’s the difference?

You may already know that your immune system uses cells to respond to viruses, bacteria, and other potentially harmful things. As part of this response, your immune system uses proteins. In the case of Crohn’s disease, these proteins play a part in creating the inflammation that causes your symptoms. Biologics and targeted oral small molecule drugs both target proteins and may reduce their ability to cause inflammation, but differ in some ways.

A key difference:

Biologics are genetically engineered proteins that are created in a laboratory from living organisms. They're given by injection or infusion. Targeted oral small molecules are synthetic medications taken in pill form.

How do biologics work?
Let's get specific.

When it comes to Crohn’s disease, certain biologics can target specific proteins that are thought to be related to inflammation in the gastrointestinal (GI) tract, and help to stop their ability to cause inflammation.

Biologics are injections or infusions

They can be administered weekly, monthly, or every few months, depending on the individual and the medication.

Types of biologics for Crohn’s disease

Many different proteins can contribute to inflammation. Since biologics attach only to specific proteins, that means each type of biologic helps to reduce inflammation caused by a specific protein. Biologics for Crohn's include:

Interleukin (IL) Inhibitors

There are many kinds of IL proteins and each one has a unique role in the immune system. IL-23 and IL-12 are two IL proteins that are thought to play a significant role in Crohn's inflammation. IL-23 and IL-12 inhibitors block these proteins, preventing them from telling the immune system to create cells that drive inflammation.

Anti-Tumor Necrosis Factor (Anti-TNF) Agents

These biologics work by binding and blocking a small protein called TNF-alpha, which helps reduce inflammation in the intestine as well as other organs and tissues. While biologics that target TNF-alpha can help patients with Crohn’s, they tend to be used for those whose Crohn’s is resistant to steroids. Some anti-TNF-alpha biologics can also treat patients with fistulizing disease.

Fistulizing disease

Fistulizing disease occurs when inflammation in the intestine causes ulcers to form. These ulcers are known as fistulas and can extend through the entire thickness of the bowel wall. This creates a tunnel which can drain the pus from an infected area.

Integrin Receptor Antagonists

These biologics can stop certain inflammatory cells from moving from blood vessels to tissues (like the intestine). They work by blocking a unique protein on cell surfaces. These biologics tend to be used on patients who didn’t respond to or couldn’t tolerate other treatments.

More about small molecules

Targeted oral small molecules are taken by mouth. Because of their size, they can be transported through the bloodstream to the immune system. Targeted oral small molecules can interrupt inflammation by targeting and blocking the signals of multiple cytokines. They help to decrease inflammation in the gastrointestinal (GI) tract.

Is a biologic or targeted oral small molecule right for me?

Biologics and targeted oral small molecules are prescription medicines for people with moderate to severe Crohn's. Biologics can be used for people who have tried other treatments first or for people who have not tried other treatments. Targeted oral small molecules are used for people in whom certain other treatments did not work well. That's why you should have an open conversation with a gastroenterologist to learn more about the risks and benefits of these medications to see if they may be an appropriate treatment option for you.

Interested in a treatment option?

Next page:

To learn more about treatments, Team Up with a Gastroenterologist