What monitoring is needed for ulcerative colitis drugs?

Question

Hello doctor,

I am 37 years old, female, and I am taking medication for my ulcerative colitis condition. I have some queries about possible side effects of these medications. Can you kindly explain to me the working of immunosuppressive or biological medicines in simple language?

Further, can you tell me whether these medicines can cause any infections and what issues should be considered in case of women patients, especially regarding bone problems and cancer risks? Moreover, how frequently should I get checked during the use of these medicines?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concerns.

Ulcerative colitis develops when the body's immune system accidentally attacks the lining of the colon, leading to inflammation. These drugs generally developed specifically to inhibit this response from the immune system so that healing and remission can take place.

The drugs, which include Azathioprine or Methotrexate, belong to the class of immunosuppressants, which inhibit certain immune cells responsible for inflammation. The biologics, such as Infliximab or Adalimumab, target the process of inflammation itself and inhibit certain inflammatory proteins, which cause injury to the colon. Through their use, one can avoid flare-ups and promote remission of the condition.

However, as the drugs used reduce some of the functions of the immune system, there is a slight possibility of infection because the body becomes less responsive to them. These infections might be caused by various agents such as bacteria or viruses, like tuberculosis. For this reason, patients should be screened before treatment to exclude any possible infections and receive vaccinations.

In case of women, there are several other factors that need to be considered. There is a chance that the health of bones may get impacted, especially when steroids like Prednisolone are used multiple times. It may be recommended by the doctors to have sufficient calcium and Vitamin D in the diet along with bone density testing from time to time. Some immunosuppressants used for prolonged periods may have a slight chance of causing cancer like skin cancer or lymphoma. Hence, regular monitoring is required.

Monitoring is very crucial in the treatment process. Every two or three months blood tests should be conducted for checking blood counts and liver functions with immunosuppressants. The colonoscopy surveillance is started usually after eight to ten years of diagnosis and conducted every year or two or three depending on the severity of the disease and previous results.

With the right kind of monitoring and medical attention, these treatment processes are common and widely used helping many people live an active and healthy life.

I hope this helps.

Thank you.