Published on REMICADE® (http://www.remicade.com)

Treatment Options

It's important to learn all you can about treating UC

A variety of treatments [1] are available for ulcerative colitis (UC). The location and severity of your disease, accompanying complications, and your response to previous treatment will influence your gastroenterologist's choice of therapy. Treatment options can be divided into 2 general categories:

Conventional therapies, which include anti-inflammatories (5-ASAs and steroids) and immunomodulators (these suppress the immune system)
Biologic Therapy works to block a protein [2] in your body that leads to inflammation.
Too much of this protein can lead to the painful symptoms of UC

Goals of treatment

There are a number of important goals of treatment:

Induce and maintain symptom control
Heal the intestine or mucosa
Reduce need for long-term steroid use

Medication

It's important to find the treatment that's right for you. Discuss your symptoms with your doctor [3] and he or she will determine appropriate treatment options. Currently available treatments for UC include, but are not limited to:

Class	Description	Example
5-ASAs (aminosalicylates)	Can be effective in treating mild to moderate symptoms and preventing relapses.	Asacol^®* (mesalamine), Pentasa^®* (mesalamine)
Steroids	An effective anti-inflammatory medication, and may help achieve short-term control over symptoms of UC. But they may lead to unwanted side effects, especially when used over the long term.	Entocort^® EC* (budesonide), prednisone
Immunomodulators	Suppress the immune system, may be used to maintain remission and decrease the need for steroids.	Imuran^®* (azathioprine), Purinethol^®* (mercaptopurine)
Biologic Therapy	Works to block a protein in your body that leads to inflammation and the painful symptoms of UC.	REMICADE^® [4]

*Indicated trademarks are registered trademarks of their respective owners.

REMICADE^® is not right for everyone.

SELECTED IMPORTANT SAFETY INFORMATION

REMICADE^® can lower your ability to fight infections. Serious and sometimes fatal events can occur. There have been reports of serious infections including tuberculosis (TB) and infections caused by bacteria, fungi, or viruses that have spread throughout the body. Lymphoma, including a fatal kind called hepatosplenic T-cell lymphoma, and other cancers have been reported in children and adults taking REMICADE^®. Some people with heart failure should not take REMICADE^®. Other serious side effects reported include skin cancer, hepatitis B, liver injury, blood problems, allergic reactions, nervous system problems, or lupus-like syndrome. To learn more about these and other risks, please read the Important Safety Information [5] and the Medication Guide [6], and talk with your doctor.

Download the Medication Guide [6] to learn more about REMICADE^®. (Requires Adobe^® Reader^®. Click here [7] to download.)

Control of UC

Some people may experience periods when the disease is inactive (few or no symptoms). These periods are called remissions. They alternate with times when symptoms worsen and persist, called flares. However, symptoms usually recur at various times during a person's lifetime. It's not possible to predict when a remission may occur or when symptoms will return. Because of the unpredictability of UC, you may need medical care for as long as your gastroenterologist deems necessary, with regular office visits to monitor your condition.

NEXT: About REMICADE^® [8] NEXT: How REMICADE^® works [2]

IMPORTANT SAFETY INFORMATION

Only your doctor can recommend a course of treatment after checking your health condition. REMICADE^® (infliximab) can cause serious side effects such as lowering your ability to fight infections. Some patients, especially those 65 years and older, have had serious infections caused by viruses, fungi or bacteria that have spread throughout the body, including tuberculosis (TB) and histoplasmosis. Some of these infections have been fatal. Your doctor should monitor you closely for signs and symptoms of TB during treatment with REMICADE^®.

Unusual cancers have been reported in children and teenage patients taking TNF-blocker medicines. Hepatosplenic T-cell lymphoma, a rare form of fatal lymphoma, has occurred mostly in teenage or young adult males with Crohn’s disease or ulcerative colitis who were taking REMICADE^® and azathioprine or 6-mercaptopurine. For children and adults taking TNF blockers, including REMICADE^®, the chances of getting lymphoma or other cancers may increase.

You should discuss any concerns about your health and medical care with your doctor.

What should I tell my doctor before I take REMICADE^®?

You should let your doctor know if you have or ever had any of the following:

Tuberculosis (TB) or have been near someone who has TB. Your doctor will check you for TB with a skin test. If you have latent (inactive) TB, you will begin TB treatment before you start REMICADE^®.
Lived in a region where certain fungal infections like histoplasmosis or coccidioidomycosis are common.
Infections that keep coming back, have diabetes or an immune system problem.
Any type of cancer or a risk factor for developing cancer, for example, chronic obstructive pulmonary disease (COPD) or had phototherapy for psoriasis.
Heart failure or any heart condition. Many people with heart failure should not take REMICADE^®.
Hepatitis B virus (HBV) infection or think you may be a carrier of HBV. Your doctor will test you for HBV.
Nervous system disorders (like multiple sclerosis or Guillain-Barré syndrome).

Also tell your doctor if you:

Use the medicines Kineret (anakinra), Orencia (abatacept) or Actemra (tocilizumab) or other medicines called biologics used to treat the same problems as REMICADE^®.
Are pregnant, plan to become pregnant, are breast-feeding, or have a baby and were using REMICADE^® during your pregnancy. Tell your baby’s doctor about your REMICADE^® use before the baby receives any vaccine because of an increased risk of infection for up to 6 months after your last dose of REMICADE^® you received during your pregnancy.
Adults and children should not receive a live vaccine while taking REMICADE^®.

What should I watch for and talk to my doctor about before or while taking REMICADE^®?

The following serious (sometimes fatal) side effects have been reported in people taking REMICADE^®.

You should tell your doctor right away if you have any of the signs listed below:

Infections (like TB, blood infections, pneumonia)—fever, tiredness, cough, flu, or warm, red or painful skin or any open sores. REMICADE^® can make you more likely to get an infection or make any infection that you have worse.
Lymphoma, or any other cancers in adults and children.
Skin cancer—any changes in or growths on your skin.
Heart failure—new or worsening symptoms, such as shortness of breath, swelling of your ankles or feet, or sudden weight gain.
Reactivation of HBV—feeling unwell, poor appetite, tiredness, fever, skin rash and/or joint pain.
Liver injury—jaundice (yellow skin and eyes), dark brown urine, right-sided abdominal pain, fever, or severe tiredness.
Blood disorders—fever that doesn’t go away, bruising, bleeding or severe paleness.
Nervous system disorders—numbness, weakness, tingling, changes in your vision or seizures.
Allergic reactions during or after the infusion—hives, difficulty breathing, chest pain, high or low blood pressure, swelling of face and hands, and fever or chills.
Lupus-like syndrome—chest discomfort or pain that does not go away, shortness of breath, joint pain, rash on the cheeks or arms that gets worse in the sun. The more common side effects with REMICADE^® are respiratory infections (that may include sinus infections and sore throat), headache, rash, coughing and stomach pain.
Psoriasis—new or worsening psoriasis such as red scaly patches or raised bumps on the skin that are filled with pus.

For more information, please download the Full Prescribing Information and Medication Guide and discuss it with your doctor.

You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Source URL: http://www.remicade.com/ulcerative-colitis/treatment-options

Links:
[1] http://www.remicade.com/ulcerative-colitis/treatment-options#medication
[2] http://www.remicade.com/ulcerative-colitis/how-remicade-works
[3] http://remicade.com/ulcerative-colitis/managing-treatment
[4] http://remicade.com/ulcerative-colitis/about-remicade
[5] http://www.remicade.com/ulcerative-colitis/treatment-options#isi
[6] http://www.remicade.com/shared/product/remicade/medication-guide.pdf
[7] http://get.adobe.com/reader
[8] http://www.remicade.com/ulcerative-colitis/about-remicade