Several treatment options are available to help manage inflammatory bowel disease (IBD). These options come in different forms and can be taken in various ways. Most commonly, IBD therapies are provided orally (PO), subcutaneously (SQ), or intravenously (IV). Each therapeutic option and route of administration carries its own benefits and risks. This article will discuss each of these options and why IV infusion therapy may be of particular benefit to patients.

Overview of IBD therapies and routes

IBD medications include corticosteroids, 5-ASA drugs, immunomodulatory agents, and biologics. Corticosteroids have anti-inflammatory properties, which is why they are used for quick and short-term relief of IBD symptoms. Corticosteroids can be taken by mouth, as an enema, or via an IV infusion. In addition, 5-ASA medications, also known as aminosalicylic acids, are another common class of medication indicated for IBD that come in many forms. Mesalazine, for example, is available as oral tablets. Other types of 5-ASA drugs can be supplied as suppositories, foams, and enemas. IBD can also be treated with immunomodulatory agents such as azathioprine or methotrexate. Immunomodulatory agents are available in oral or injection formulations. Finally, IBD can be treated with biologic medications that are given IV1.

Benefits of IV medication

The intravenous route of administration delivers medication directly into your bloodstream. Because it utilizes this method, a medication can enter your bloodstream and system more quickly compared with other routes. When taking a drug by mouth, your body must undergo an absorption process that takes time and usually does not absorb 100 percent. IV infusion allows your body to achieve adequate drug levels in the blood faster, causing a more rapid and sustained therapeutic effect2. Because of this, IBD patients commonly turn to IV agents instead of oral or injection medications.

In the context of IBD, common infusions therapies can include biologic medications such as Remicade (infliximab), Entyvio (vedolizumab), Stelara (ustekinumab), or Cimzia (certolizumab pegol)3 These agents are highly efficacious, thereby providing relief to many patients with IBD. These therapies have a robust efficacy profile for IBD compared with other medications that are given orally or via SQ injection. They are particularly useful for IBD cases that are unresponsive to oral medications.

As an example, consider the treatment of Crohn’s disease, which is a form of IBD. One study evaluated how Remicade compares with conventional oral treatment for Crohn’s as first-line therapy (azathioprine). Results indicated that using Remicade as a first-line treatment achieved superior outcomes compared with azathioprine therapy alone. On average, patients receiving Remicade were more likely to achieve remission, demonstrating better efficacy4.

In addition to an improved efficacy profile with IV infusion therapy, some patients prefer IV administration for convenience and safety purposes, particularly compared with subcutaneous delivery. Some patients may prefer IV administration under medical supervision as opposed to self-injecting medication themselves. This also allows for greater compliance due to the oversight of a medical professional. Additionally, IV infusions are usually less frequent, occurring every eight weeks as opposed to every one to two weeks. This can provide greater convenience for the patient5. IBD patients can receive infusion therapy at home or at a conveniently located infusion center with ContinuumRx and Continuum Health. Contact us to onboard your therapy today!

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References

  1. Medication for inflammatory bowel disease in adults. (n.d.). Retrieved April 14, 2022, from https://nyulangone.org/conditions/inflammatory-bowel-disease-in-adults/treatments/medication-for-inflammatory-bowel-disease-in-adults
  2. Routes of drug administration. (2018). https://doi.org/10.1016/B978-0-12-801238-3.11099-2
  3. Infusion therapy for Crohn’s disease. (n.d.). Infusion Associates. Retrieved April 14, 2022, from https://infusionassociates.com/infusion-therapy/crohns-disease/
  4. Jongsma, M. M. E., Aardoom, M. A., Cozijnsen, M. A., van Pieterson, M., de Meij, T., Groeneweg, M., Norbruis, O. F., Wolters, V. M., van Wering, H. M., Hojsak, I., Kolho, K.-L., Hummel, T., Stapelbroek, J., van der Feen, C., van Rheenen, P. F., van Wijk, M. P., Teklenburg-Roord, S. T. A., Schreurs, M. W. J., Rizopoulos, D., … de Ridder, L. (2022). First-line treatment with infliximab versus conventional treatment in children with newly diagnosed moderate-to-severe Crohn’s disease: An open-label multicentre randomised controlled trial. Gut, 71(1), 34–42. https://doi.org/10.1136/gutjnl-2020-322339
  5. Jonaitis, L., Marković, S., Farkas, K., Gheorghe, L., Krznarić, Ž., Salupere, R., Mokricka, V., Spassova, Z., Gatev, D., Grosu, I., Lijović, A., Mitrović, O., Saje, M., Schafer, E., Uršič, V., Roblek, T., & Drobne, D. (2021). Intravenous versus subcutaneous delivery of biotherapeutics in IBD: An expert’s and patient’s perspective. BMC Proceedings, 15(17), 25. https://doi.org/10.1186/s12919-021-00230-7
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