Biologics: the New Frontier

It is not a pleasant subject, but inflammatory bowel disease (IBD) is a fact of life for many people. That's especially tough when you are a child.

“There are about four million people in the U.S. with IBD,” says Ritu Walia, M.D., pediatric gastroenterologist at Sinai Hospital. “About 5,000 people are diagnosed with IBD each year.
There are 50,000 to 100,000 children in the U.S. with it,” she says.

IBD includes Crohn’s disease and ulcerative colitis. IBD should not be confused with irritable bowel syndrome (IBS), although both are intestinal tract conditions and have similar symptoms of . IBS is not a disease and doesn’t increase the risk of colon cancer. IBD, in constrast, is characterized by inflammation in the small and/or large intestines and can increase the risk of cancer.

Dr. Walia presented "Biologics in the Care of IBD" as part of the Dr. Jennifer Ann Kierson Memorial Pediatric Grand Rounds Series on February 15. Traditionally, physicians have prescribed steroids like Prednisone, which can cause “huge side effects.” Dr. Walia says. Some possible side effects of steroids are slowing growth and bone development, hypertension, osteoporosis, bloating and mood swings, among other things.

Biologics, on the other hand, are proteins that prevent substances in the body that cause inflammation. They do not cause the same side effects of steroids but the patient’s immune system should be monitored. One recent article in Gastroenterology and Endoscopy News pointed out that while every patient is different, "current evidence suggests that biologic therapy will significantly reduce the most severe consequences of [Crohn's Disease]."

Even though biologics are more expensive, perhaps it is time for the medical profession to consider treatment with biologics as the first line of defense in treating IBD and not the last, Dr. Walia concludes.

Treatment with biologics is “steroids-sparing, improves the quality of life and facilitates normal growth and development,” says Dr. Walia, which is especially important for a child with IBD.
-Sandra Crockett