II. Indications
- Moderate to severe Inflammatory Bowel Disease (refractory to TNF Inhibitors)
III. Contraindications
- Severe Infection
IV. Mechanism
V. Precautions
- See Monoclonal Antibody for preparation before first dose
VI. Dosing
- Induction: Infuse 300 mg IV over 30 minutes at week 0, 2 and 6 weeks
- Maintenance: Infuse 300 mg IV over 30 minutes every 8 weeks
- Continue if significant clinical response at 14 weeks
VII. Safety
- Pregnancy Category B
- Unknown safety in Lactation
VIII. Adverse Effects
- Anaphylaxis
- Medication reaction
- Slow infusion if symptomatic
- Consider pretreatment (e.g. Antihistamines, Corticosteroids, Acetaminophen)
- Other adverse effects
- Elevated Liver Function Tests (Transaminitis, Hyperbilirubinemia)
- Progressive Multifocal Leukoencephalopathy (case reports)
IX. Efficacy
- Slower effects than with TNF Inhibitors
X. Resources
XI. References
- (2023) Biologics for Crohn's Disease, Presc Lett, #390826
- (2023) Drugs for Inflammatory Bowel Disease, Med Lett Drug Ther 65: 105-12