What is infusion or Biologic therapy?

Infusion or Biologic therapy is the administration of medication intravenously (through the needle).  Typically, you may have already taken other medications that didn't work effectively or have stopped working. Your physician may then prescribe a Biologic if your condition is so severe that it cannot be treated effectively by oral medications.

What diseases are treated with infusion therapy?

Diseases commonly requiring infusion therapy include infections that are:

  • Unresponsive to oral antibiotics
  • Cancer and cancer-related pain
  • Dehydration
  • Gastrointestinal diseases or disorders which prevent normal functioning of the gastrointestinal system

Conditions treated with specialty infusion therapies may include:

  • Cancer
  • Congestive heart failure
  • Crohn's Disease
  • Hemophilia
  • Immune deficiencies
  • Multiple sclerosis
  • Rheumatoid arthritis

How are biologics given?

Infusion or Biologic therapy is usually an outpatient procedure and can last for about two hours or more especially if you are new to the therapy. How often you will need an infusion depends on the specific medication, but it’s typically about every one to two months.

Some Biologics are self-injected at home on a regular schedule, such as every two to four weeks. Work with your doctor to find the right biologic treatment for you.

What are the side effects of biologics?

Side effects can vary, minor side effects include a rash or skin redness at the site of injection.  For a more severe reaction, the rate of infusion may be changed or you may need to take a steroid or antihistamine before treatment. A greater concern for physicians is the risk of infection. Biologics are considered immunosuppressive medications, which means they can reduce your body’s ability to fight off infection.

Before starting biologic therapy, your physician will assess your health to monitor other health concerns. For example, you’ll be tested for Tuberculosis because taking a biologic could reactivate the lung disease. If you have Hepatitis B or heart disease, you may still be able to receive biologic therapy, but you will need extra monitoring and may need to work with other healthcare specialists to help manage your risks.

When you are on biologic therapy, your physician will perform regular exams, including blood tests, to make sure your body is properly fighting infections. Women may also be reminded about getting regular Pap smears to look for any cervical abnormalities that may develop while taking a biologic drug.

Understanding the side effects is important, but you may be considering the use of a biologic drug because your disease is more aggressive or because other therapies have failed. Speak with your physician to weigh the risks and benefits.

Do biologics increase the risk of cancer?

Crohn’s disease and biologics may also be linked to an increased risk of skin cancer.  A study published in the journal Gastroenterology in 2012 found a greater risk for melanoma and non-melanoma skin cancer in a group of people with inflammatory bowel disease, which includes Crohn’s disease. The risk of melanoma increased further when the participants took biologics. This is another risk that your doctor can help you reduce and monitor. The increased risk of cancer from using biologics is small.  There may be a small risk of developing non-Hodgkin lymphoma, but again you have to weigh the treatment benefits against this risk.

Will I use biologic therapy along with other medications?

You may be prescribed more traditional immunomodulator and anti-inflammatory drugs by your physician. By using a combination approach, your physician can help target different inflammatory responses in your body.

How long will I be taking biologics?

You may need to use it for the foreseeable future. The data still is not clear regarding how long you should use a biologic but it does appear that if you go off the drug, you are more likely to have a disease flare.

What if my health insurance will not cover the costs?

Biologic therapy is expensive because it is newer and there are no generic alternatives available. However, it should be pointed out with insurers who were not covering the medications that it would cost more if a person with Crohn’s disease, as an example, had to be hospitalized for a complication, and that has persuaded some insurers to include biologics in their coverage.

If you are not sure if you can afford the medication, talk to your Biologic Coordinator. Drug manufacturers often have assistance programs to help cover costs. You can find out more about those programs on the drug companies’ websites.

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