Crohn’s disease is a painful autoimmune condition that results from excess Tumor Necrosis Factor-alpha (TNFa) in humans. The condition can result in intestinal fistulae, pain, and significant discomfort, as well as a loss of the quality of life for patients who go without treatment. Some individuals report only minor discomfort as a result of the condition, however.
This article addresses the use of Humira, also called adalimumab, for the treatment of Crohn’s disease. This medication is not designed to treat mild cases, due to its potentially dangerous side effects. But for those with moderate to severe cases of Crohn's, this medication can be very helpful.
Read on for more information on what Humira is, how it works, how it is administered, what the side effects are, what patients have to say about it, and what the research reveals.
If you’ve just been diagnosed with Crohn’s disease, or have the condition but are looking for alternative therapies, you have probably heard about Humira. It's one of the most popular drugs, despite having been developed for the treatment of rheumatoid arthritis. Although it offers significant relief from the symptoms and pain caused by Crohn’s disease, it can also cause significant, and potentially fatal side effects. As a result, before beginning treatment, there are a few things you need to keep in mind.
What is Humira? Skip to How it Works if the scientific stuff bores you :)
The medication is a member a family of drugs called biologics, and is made using phage display technology. Humira is a recombinant lgG1 monoclonal antibody that specifically targets TNF. The medicine contains 1330 amino acids, and is produced using recombinant DNA technology in a mammalian cell expression system.
Designed for subcutaneous administration, Humira is also safe for pediatric use. The drug is available in prefilled pens, prefilled syringes, and pediatric syringes. Each 0.8mL adult dose contains 40mg of the drug. Pediatric syringes are 0.4mL and contain 20mg of the medication.
How it Works Against Crohn's Disease
The pain, inflammation, diarrhea, fistulae, and other severe symptoms associated with Crohn’s disease are the result of excess TNF (tumor necrosis factor) in the body. Like Cimzia, Humira is a TNF blocker. It works by binding excess TMF protein to prevent the symptoms associated with Crohn’s disease. The medication is used specifically in cases where individuals do not respond to other treatments, or cannot tolerate infliximab (Remicade).
Administration & Side Effects
The administration of Humira in adults begins with a 160mg dose, or 4 pens. 15 days later, a dose of two pens, or 80mg, is administered. On day 29, adult Crohn’s patients receive 1 pen, or 40mg. From this point on, patients who demonstrate a response to Humira administration receive a dose of one pen, or 40mg, every 15 days.
Humira can be effective in as little as four weeks. As a result, some patients choose to stop taking the medication. This isn’t a good move, however. The medication’s effectiveness relies on accurate and repeated dosage at the scheduled intervals. By following the regular maintenance schedule, you can reduce the number of Crohn’s flare ups you experience.
If you take the drug and experience no relief in 12 weeks or more, this may not be the right medication for you. That's when you might want to explore other options.
Like many other TNF blockers, the side effects of Humira can be severe. They include the potential for severe and systemic infections. Additionally, as with other TNF blockers, the possibility of developing cancers such as lymphoma may increase. Pediatric cancer rates also increase with this medication.
Before starting, you should let your doctor know if you have an infection, are being treated for an infection, or have the symptoms of one, if you have a history of cancer, hepatitis B, heart failure, nervous system diseases, allergies, or diabetes. Any plans for pregnancy, or current pregnancies should be mentioned, and you should also let your doctor know if you are breastfeeding. If you live, or have lived, in the Ohio or Mississippi River valleys, let your doctor know - this may place you at higher risk for certain fungal infections.
Humira commonly results in side effects such as injection site reactions, headaches, upper respiratory infections, rash, and nausea. Severe adverse reactions include serious infections (including Hepatitis B infections in carriers of the virus), allergic reactions, nervous system problems, blood problems, heart failure, psoriasis, liver problems, and immune problems (including a lupus-like syndrome).
If you have any symptoms of an infection, including fever, muscle aches, sweats, chills, shortness of breath, coughing, blood in phlegm, weight loss, fatigue, frequent urination, burning during urination, diarrhea or stomach pain, or warm, red sores on your body, call your doctor immediately.
Potential drug interactions include apatacept, infliximab, etanercept, certolizumab pegol, and simponi. Even if you are no longer on rituximab, azathioprine, or mercaptopurine (6-MP), you should let your doctor know that you were on them in the past.
Pros & Cons – According to Patients
Humira users report burning with injection of the medication. Many are very happy with the results, however. The medicine is reported as working well, and quickly. Injection site pain and skin reactions were commonly noted, too. Humira can be prohibitively expensive depending on the insurance plan and dosage form that is prescribed.
If you want to read about some of our visitor's experiences with Humira for Crohn's just follow the link to our forum.
Research & Studies on Humira
Humira has been extensively studied in Crohn’s disease patients. 1478 patients in four placebo controlled studies and two open-label extension studies were conducted. As with other TNF blockers, the study participants were predominantly female and Caucasian, which may skew the ability to distinguish differing results for minority populations. Upper respiratory infections, headache, rash, injection site irritation, and urinary tract infection were frequently noted.
Post-market self reported effects for Humira include gastrointestinal disturbances, pyrexia, liver failure, Merkel cell carcinoma, nervous system disorders, respiratory disorders, skin problems, and vascular disorders. These conditions were reported outside of clinical studies by patients, and hence may not be clearly correlated to taking the medication itself.
Suffering from Crohn's Disease can be unbearable. Consider asking your physician about whether or not Humira is a possible solution to the reduction of your symptoms. There are many individuals who have had positive experiences with the drug. Of course there are many who haven't seen success with it so one of the other alternatives might be better for you. Many Crohn's sufferers try at least two different medications before they find one that works. Lifestyle changes, dietary modifications and natural treatments might help as well.
Do you have any experiences with Humira you'd like to share? Feel free to send it along and we'll post it here on the site to help others learn more about its effectiveness for Crohns.
Types of Medication and Alternative Options