GutTalk TV by Dr Yoon An and Dr Jakob Begun (IBD specialists from Australia). They go through the “ins and outs” of IBD biologics therapy in attempt to answer all your questions.
And i’m dr jake begun we’re gastroenterologists from australia with interest in inflammatory bowel disease today we are going to talk about biologic therapy that we use in inflammatory bowel disease and today we are going to talk about adoluma map adenoma map is known as a brand name called humira which many of you will be aware of however there’s few biosimilars
There are making way it’s its way to market at this stage why am i being treated with this medication adelibmab is approved for use in a variety of inflammatory conditions and among inflammatory bowel disease it’s commonly used in crohn’s disease ulcerative colitis and perianal crohn’s disease or fistulizing crohn’s disease it’s used in both pediatric and adult
Settings how does it work it is a monoclonal antibody that works against tnf alpha protein so tnf alpha protein is produced when you have infection naturally to cause the temporal inflammation to fight against that infection however in inflammatory bowel disease patient you get overproduction of this certain protein that cause significant damage in your gut so
This medication goes in and target that protein and by reducing the number of tnf alpha protein in your body you feel better and get a healing of the gut how long does it take to work adilipimab is given first during an induction dosing regimen and that induction dosing occurs over the first 12 weeks of treatment and at that 12 week mark is when we assess whether
Or not the medication is working in general we’d like to see a good response during those first 12 weeks and ideally that patients will actually go into remission during that time how do i take adelma map well the medication comes in subcutaneous injection form so you will either receive a pen um that is already filled with the medication automatic syringe or
You can come in actual syringe form so when you have those uh medication you will be educated by the ibd nurses or any other nurses who are able to educate you on this um to inject on your um either abdomen or in your upper thigh so when you’re injecting these um there are some tips that we can pass on to to prevent any uncomfortable feeling that you may have
From this injection so it is always good to keep the medication in the fridge but before giving yourself injection take it out from the fridge and put in a room temperature for 15 to 30 minutes but you don’t want to leave it more than 30 minutes in the room temperature and make sure that you put a bit of coal pack on your inject potential injection site about
For two minutes and then um wipe it with the alcohol wipe so that it’s all disinfected and then you give yourself an injection after injection again it would be good to wipe off that area with the alcohol wipe again and the injection is done hopefully by doing this you will have reduced the stinging feelings or pain around that area during or post-it injection
Usually you get a multiple injection at the beginning during induction period but usually once you finish the induction within three months you will be on every two weeks injection which will be good how long will i be on adelitamab four if patients have a good response to induction then we generally continue adilipimab during the maintenance phase during the
Maintenance phase as dr ahn mentioned the dosing as one uh in pen or syringe every two weeks and then we will be reassessing for a continued response every six months or so and we’d like to see people get a durable remission with this medication to know that we’re really healing the gut once we’ve achieved that durable remission and you’ve been in remission for
A good length of time your specialist may talk to you about the possibility of a drug holiday when you stop the medication to see what will happen unfortunately there’s a pretty uh high risk of relapse of disease when you stop the medication so your your specialist or your ibd team will usually watch very closely and if there are signs of the disease coming back
Then you restart the medication the good news is that many people respond well to re-induction with the medication if they’ve previously been on it and done well on the other hand if people don’t respond adequately to adelibmab in the induction phase then we may increase the dose for example to one injection every week instead of every other week and see if that
Is good enough to get a response but if that doesn’t work then we’re generally thinking about switching medications because we really want to treat the disease aggressively what are the possible side effects of adolemma map well i don’t remember it’s well tolerated on patients that receive this medication however i’m just going to highlight a few of the common
Side effects that’s been reported and the common thing is obviously the injection site reaction and that’s why i pass on the tips before to prevent that reaction happening other than that from the medication that you’re receiving you can have some skin problems including psoriasis and you can have worsening of joint pain from this medication and also because
This is an immune suppression you can have increased incidence of infection so common infection that you can get from this medication is upper respiratory tract infection urinary tract infection and so on people are a bit nervous about coronal virus pandemic at this stage but it is safe to use um during um this pandemic and what’s been reported so far does not
Increase the incidence of um crevit 19 infection that’s right or the severity um and will i need to take any special precautions while being treated with adelibumab uh because of the infectious risks that dr uh on highlighted we do screen for certain infections prior to initiation of adelipimab so we’ll do blood tests to look to see if patients have been exposed
To tuberculosis and adequately treated if they are or if there are any viruses that you have that might be of risk once we start adolph map in addition we look to see that you are immune to other viruses and if not then that is a window of opportunity to vaccinate against those when you’re on adolib we recommend some routine health maintenance advice which includes
Getting an annual influenza vaccination while on the medication an intermittent pneumococcal vaccination depending on the type of vaccine that you’re receiving and also uh routine health maintenance such as pap smears skin checks etc and can i have immunization while on at aluma map well at aluminum map suppress the immune system so we have to be careful when
We consider immunization like dr bigan already said flu vaccination pneumococcal vaccination are safe while you’re on this medication however you want to avoid life vaccination and whenever you’re getting immunized always ask your practitioner whether this is like vaccine or inactive vaccine does adelibe map affect pregnancy adelibam has been on the market for
Over 15 years now and during that time there have been many women who have become pregnant while on the medication fortunately by studying these groups of people we know that adelibmab is extremely safe during pregnancy there are no adverse major adverse events that it causes during pregnancy to the mom and no effects on baby either the adolib monoclonal antibody
That we described does cross the placenta so it will go into fetal circulation and b in the baby when it’s born and for that reason if patients are doing very well specialists will sometimes hold a dose or two of the adelib map in the third trimester regardless though we do recommend against live vaccinations in the baby after birth for the first 6 to 12 months
Of life but in general all the other vaccines that they receive are perfectly fine and with respect to breastfeeding adelibmab is also very safe in this context because even though adillipimab does go into the breast milk and get expressed there it can’t be absorbed across the gut so the baby doesn’t get any adelibmab in its bloodstream from drinking the breast
Milk so overall adolume is very effective medication for infringement disease and we see good responses in most people um if you have any questions you always should ask your iv team before or while you’re on this medication if you have any questions or comments please leave it below and don’t forget to press the subscribe button so you get all the news from our channel
Transcribed from video
Adalimumab (Humira) – IBD treatments explained by the experts By GutTalk TV