Which medications in the drug class Monoclonal Antibodies are used in the treatment of Crohn Disease?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

Monoclonal Antibodies

Monoclonal antibodies are used in the treatment of moderate-to-severe active Crohn disease or fistulizing disease that is unresponsive to other medical therapy.

Infliximab (Inflectra, Remicade)

Infliximab is a chimeric mouse-human monoclonal antibody against tumor necrosis factor (TNF)-α that shows promise in the treatment of Crohn disease. This agent blocks TNF-α in the serum and at the cell surface, leading to the lysis of TNF-producing macrophages and T cells. Infliximab has been approved for the treatment of pediatric Crohn disease.

Adalimumab (Amjevita, Cyltezo, Humira, Hadlima, Hyrimoz, Adalimumab-atto, Adalimumab-adbm, Adalimumab-bwwd, Adalimumab-adaz)

Adalimumab is indicated for the induction and remission of moderate-to-severe active inflammatory Crohn disease. This agent is a recombinant human immunoglobulin (Ig) G1 monoclonal antibody specific for human TNF. It binds specifically to TNF-α and blocks interaction with p55 and p75 cell-surface TNF receptors. This interferes with the cytokine driven inflammatory processes. Adalimumab also lyses surface TNF-expressing cells in vitro in the presence of complement, but it does not bind to TNF-β (lymphotoxin). The FDA approved adalimumab-atto, adalimumab-adbm, adalimumab-adaz, adalimumab-bwwd as biosimilars and not as interchangeable drugs.

Certolizumab pegol (Cimzia)

Certolizumab pegol is indicated for moderate-to-severe Crohn disease in individuals whose condition has not responded to conventional therapies. It is a pegylated anti–TNF-α blocker, and its action results in disruption of the inflammatory process.

Ustekinumab (Stelara)

Ustekinumab inhibits interleukin (IL)-12 and IL-23 cytokines, which play a key role in inflammatory and immune responses. It is indicated for adults with moderately to severely active Crohn disease who have failed or were intolerant to immunomodulators or corticosteroids, but never failed treatment with a tumor necrosis factor (TNF) blocker. It is also indicated for those who failed or were intolerant to treatment with 1 or more TNF blockers.


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