What are 5-aminosalicylates (5-ASA) agents?

  • these are mesalamine containing compounds, with very few side effects
  • e.g. Asacol, Mesavant, Pentasa, Salofalk
  • they can be taken orally once to several times a day
  • there are topical forms (liquids, foams, suppositories that melt) which were made to coat the inner lining of the rectum and last part of the colon
    • the topical therapies may help with healing of the rectum (and help with the symptoms of urgency, rectal bleeding)

What are Immunosuppressants?

  • these are medications designed to suppress or modify the immune system
  • thiopurines (e.g. azathioprine (Imuran), 6-mercaptopurine (Purinethol)
  • methotrexate (must STOP BEFORE attempting to become pregnant)
  • steroids (e.g. prednisone, budesonide)

What are Biologics?

  • these are medications that were designed to specifically target a protein or a pathway of the inflammatory and immune responses
  • currently the approved biologics include antibodies (proteins that bind to other proteins) that block certain inflammatory pathways that are thought to lead to IBD
    • anti-tumour necrosis factor-alpha (anti TNF-a)
      • inflixmab (Remicade, Inflectra), adalimumab (Humira), golimumab (Simponi)
    • anti-interleukin (anti IL12/23)
      • ustekinumab (Stelara)
    • anti-integrin (anti-a4b7 )
      • vedolizumab (Entyvio)
  • these are given by intravenous infusions (IV), subcutaneous (just under the skin) injections (SC), or a combination of IV and SC

 

For more information about IBD medications and pregnancy, click here.