Entocort vs. Tysabri for Crohn's Disease: Important Differences and Potential Risks.

Key takeaways

Budesonide (Entocort EC) and natalizumab (Tysabri) are both used to treat Crohn's disease, but they belong to different medication classes. Budesonide is a corticosteroid that helps reduce inflammation in the intestines, while natalizumab is an integrin antagonist that may work by blocking signals that cause inflammation. Budesonide is taken orally as a capsule once daily, whereas natalizumab is given as a monthly intravenous (IV) infusion by a healthcare professional. Budesonide is available as a generic, making it a more cost-effective option, while natalizumab is only available as a brand-name medication. Common side effects of budesonide include headache and respiratory infections, while natalizumab can cause headaches and fatigue. Both medications can increase the risk of infections, but natalizumab has a higher risk of serious infections, including a rare brain infection called progressive multifocal leukoencephalopathy (PML). Additionally, natalizumab requires enrollment in a special monitoring program due to its risks.

Budesonide

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Tysabri

(natalizumab)

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Summary for Entocort

Prescription only

Budesonide is a corticosteroid that's used to treat mild-to-moderate Crohn's disease in adults and children. It's available as capsules that are taken by mouth once daily. The most common side effects are headache and respirator infections. More rarely, it might cause weight gain too.

Indications for Entocort

Mild-to-moderate active Crohn's disease in people ages 8 years and older
Maintenance of remission of Crohn's disease in adults

Pros and Cons for Entocort

Pros

Works where you have symptoms in your intestines (gut)
Might cause fewer side effects than other steroids
Taken once a day
Available as a lower-cost generic

Cons

Not recommended for long-term use
Might not work as well as other steroids like prednisone
Can raise your risk for infections
Can take a couple months to see full benefit from the medication

Common Side Effects for Entocort

Treatment of active, mild-to-moderate Crohn’s disease:

Headache (21%)
Infection in your air passageway (respiratory infection; 11%)
Nausea (11%)
Back pain (7%)
Dizziness (7%)
Upset stomach or indigestion (6%)
Gas (6%)
Stomach pain (6%)
Vomiting (6%)
Feeling tired (5%)
Pain (5%)

Maintenance of remission of Crohn’s disease**:

Diarrhea (10%)
Sinus inflammation (8%)
Viral infection (6%)
Joint pain (5%)

** Side effects listed are in addition to those observed with treatment of active Crohn's disease.

Warnings for Entocort

Changes in stress hormone levels in the body
Higher risk of infections
Worsening of certain medical conditions

Summary for Tysabri

Prescription only

Tysabri (natalizumab) is an injectable medication used to treat relapsing forms of multiple sclerosis (MS) in adults. It can also treat moderate-to-severe Crohn's disease (CD) in adults. It works as an integrin antagonist to help lower inflammation in the body. Tysabri (natalizumab) is given by a healthcare professional as an infusion into a vein once a month. Common side effects include headache and fatigue. Because it has a risk of serious infections, you must enroll in the Tysabri TOUCH Program before starting treatment.

Indications for Tysabri

Relapsing forms of multiple sclerosis (MS)
Moderate-to-severe Crohn's disease (CD) when other treatments haven't worked well

Pros and Cons for Tysabri

Pros

Infusions are once every month
Can help reduce relapses in MS
An option for Crohn's disease when other treatments haven't worked well

Cons

Must be given by a healthcare professional in a healthcare setting
Raises your risk of serious infection
Only FDA approved for adults

Common Side Effects for Tysabri

Headache (38%)
Fatigue or feeling very tired (27%)
Urinary tract infection (21%)
Joint pain (19%)
Depression (19%)
Lower respiratory tract infection (17%)
Pain in arm or leg (16%)
Rash or other skin irritation (up to 12%)
Stomach discomfort (11%)
Diarrhea (10%)

Warnings for Tysabri

Risk of a brain infection leading to progressive multifocal leukoencephalopathy (PML)
Risk of other infections
Liver problems
Allergic reaction or infusion reaction
Low platelet levels
Other lab changes