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Wednesday, May 14, 2014

Cimzia - Part 1

          After a couple of weeks with some moderate, uncomfortable stomach pain, I woke up this morning with no pain at all. What a relief! I gave myself the Cimzia injections last night, but I didn't think they'd help this quickly. I was able to take deeper breaths, stand up taller, and walk with a pep in my step. I could...move! I felt like running, which I haven't had the desire to do for nearly two months. So, what is Cimzia and how does it treat Crohn's?

          First, let's look at what Crohn's disease is. It's an autoimmune disease. Basically, my immune system mistakenly attacks bacteria that are naturally present in my gut. I like the paragraph below from http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/ because I think it simply explains it in more detail.

    The GI tract normally contains harmless bacteria, many of which aid in digestion. The
    immune system usually attacks and kills foreign invaders, such as bacteria, viruses,
    fungi, and other microorganisms. Under normal circumstances, the harmless bacteria
    in the intestines are protected from such an attack. In people with IBD, these bacteria
    are mistaken for harmful invaders and the immune system mounts a response. Cells
    travel out of the blood to the intestines and produce inflammation (a normal immune
    system response). However, the inflammation does not subside, leading to chronic
    inflammation, ulceration, thickening of the intestinal wall, and eventually causing
    patient symptoms.

This is really all we need to understand about Crohn's in order to understand how Cimzia treats the disease.

           Second, before I get into how Cimzia treats Crohn's, I want to make sure it's clear that Cimzia does not cure Crohn's it only treats the disease. I know it's crazy about $3,000 each month for a drug that doesn't even cure me. Luckily, with insurance and a co-pay card I get it for free.  Cimzia is a biologic medication, which means its derived, in some way, from living organisms. As you can imagine, biologic meds are complex and I don't even begin to understand how they're made, but it's interesting to research even though the science behind it is way over my head. Cimzia  is used to treat numerous autoimmune conditions, not just Crohn's. The easiest way to explain Cimzia is to cite from its website: http://www.cimzia.com/crohns-disease/crohns-symptoms/crohns-disease-medication-information.aspx

    In people with Crohn's disease, the immune system produces too much of a protein
    called tumor necrosis factor-alpha (TNF-alpha). TNF-alpha triggers inflammation,
    which can lead to inconvenient and often painful symptoms, some of which can cause
    damage to your gastrointestinal tract

    CIMZIA blocks the action of TNF, a substance produced by cells of the immune
    system to induce inflammation. CIMZIA is the first and only PEGylated biologic
    treatment for Crohn's disease. PEGylation has been shown to help the medicine stay
    in the body.

The way I understand it is that TNF is responsible for attacking the good bacteria and causes the inflammation. Cimzia is a TNF blocker, so it blocks the TNF, which reduces inflammation and reduces symptoms. One of the dangerous things about taking a drug that blocks TNF is that I have no immune system that will come to my rescue to fight foreign invaders, like infections.

          In conclusion, sometimes I wonder how I can be okay with injecting such a powerful drug into my body. The body is a temple, right?  Cimzia stops my body from working the way it's supposed to work. My reasoning is that if I left my body alone (without drugs) to work how it's supposed to work, it malfunctions and causes me pain. Sometimes I'm not okay with that reasoning. Especially, when I think of all the side effects and risk factors associated with the drug. I'll save that for the topic of part 2.