NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Crohn’s Disease: Use of Biologics in Adults

Crohn’s Disease: Use of Biological Agents in Adult Patients

The NHSGGC guideline previously entitled ‘Anti Tumour Necrosis Factor Alpha Medications In Adult Crohn’s Disease’ has been reviewed and updated. This is now available on the Clinical Guideline Repository on StaffNet here.

Summary of main changes

  • Information now included on the four biological agents licensed in adult Crohn’s disease; infliximab, adalimumab, vedolizumab and ustekinumab
  • Information now included on therapeutic drug monitoring of anti-TNF agents, infliximab and adalimumab. This has recently emerged as a helpful tool for optimising the use and effectiveness of these drugs
  • Flow charts added summarising how to manage secondary loss of response to these agents
  • Pregnancy and breast feeding section updated and includes additional information on conception and contraception, pre-pregnancy planning, and immunisation of infants exposed to biologic therapy

Key messages

  • Infliximab and adalimumab are NHSGGC 1st line agents of choice
  • Biologic treatment should be initiated and reviewed regularly by specialist clinicians with experience of biologic therapy and managing Crohn’s Disease. Patients will be reviewed to ensure there is an ongoing indication and to monitor for adverse effects
  • Although not prescribed in primary care, it is beneficial for biologics to be added to GP prescribing systems. See here for further information


Published 20/08/18