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How do TNF inhibitors treat inflammatory bowel disease?

Dr. Darria Long Gillespie, MD
Emergency Medicine
TNF inhibitors are biologic drugs that prevent immune system cells from causing inflammation and damaging the intestines. They do this by blocking the action of a substance called tumor necrosis factor (TNF). TNF inhibitors that are approved by the FDA to treat either Crohn's disease or ulcerative colitis (UC) or both include adalimumab (Humira), certolizumab pegol (Cimzia), golimumab (Simponi), and infliximab (Remicade, Inflectra). These drugs are given by injection. 

Adalimumab, certolizumab pegol, and infliximab are FDA-approved to treat Crohn's disease. They are used to treat moderate or severe active disease and to maintain remission. They are usually given to people who have not improved with other treatments, such as corticosteroids or thiopurines. Often, a person is treated with both a TNF inhibitor and a thiopurine or methotrexate until their Crohn's disease is in remission.

TNF inhibitors are also given to people whose Crohn's disease is in remission, to prevent relapse. People who are in remission after TNF inhibitor treatment are often continued on the TNF inhibitor. People who are in remission after corticosteroid treatment are sometimes started on a TNF inhibitor. These drugs have been shown to be effective at maintaining remission. Over time, a TNF inhibitor may become less effective for a person.

Adalimumab, golimumab, and infliximab are FDA-approved to treat UC. They are used for moderate or severe active disease that has not been controlled by corticosteroids or thiopurines. They are also effective for maintaining remission in people whose active disease was controlled by a TNF inhibitor.

Adalimumab and infliximab are FDA-approved to treat children age 6 or older with Crohn's disease. Infliximab is FDA-approved to treat children age 6 or older with UC. As in adults, these TNF inhibitors are used for children with more severe active disease, those who have not improved with other treatments, and occasionally for maintaining remission. 

This answer was adapted from Sharecare's award-winning AskMD app. Start a consultation now to find out what's causing your symptoms, learn how to manage a condition, or find a doctor.

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