• Abnormalities in the mucosa
• Gross abnormalities and pathology
• Extraintestinal manifestations

Abnormalities in the mucosa

Crohn's disease (CD) evolves from an excessive and persistent inflammatory immune response (likely a response to microflora in the lumen), in which bacteria infiltrate the intestinal epithelium causing inflammation of the full thickness of the bowel.¹

Gross abnormalities and pathology

An overall effect of inflammation of the mucosa is fibrosis that can affect the full thickness of GI tissue and result in loss of functional anatomy of the GI tissue.² Fibrosis is the formation of fibrous tissue as a reparative or reactive inflammatory process, with fibrous tissue being composed of bundles of collagenous white fibers between connective tissue.³ Upon the formation of this fibrous tissue, the barrier between intestinal tissue layers is no longer distinct. This thickening of the mucosa leads to failure of the muscle coat and failure of the nerve plexuses to allow for peristalsis.²

Extraintestinal manifestations

The presence of inflammatory bowel disease (IBD) may stimulate the emergence of other disorders. Extraintestinal complications develop in approximately one-quarter to one-third of patients with IBD and can be divided into 3 categories⁴:

• Those intimately related to the activity or extent of disease, such as arthritis or iritis
• Those independent of the severity of disease, such as sclerosing cholangitis or ankylosing spondylitis
• Those that result from inadequate or disordered intestinal function, such as cholelithiasis or nephrolithiasis

Indication
CIMZIA is indicated for reducing signs and symptoms of Crohn's disease and maintaining clinical response in adult patients with moderately to severely active disease who have had an inadequate response to conventional therapy.

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Indication
CIMZIA is indicated for reducing signs and symptoms of Crohn's disease and maintaining clinical response in adult patients with moderately to severely active disease who have had an inadequate response to conventional therapy.

Important Safety Information
Serious and sometimes fatal side effects have been reported with CIMZIA, including tuberculosis (TB), bacterial sepsis, invasive fungal infections (such as histoplasmosis), and infections due to other opportunistic pathogens (such as Legionella or Listeria). Patients should be closely monitored for the signs and symptoms of infection during and after treatment with CIMZIA. Lymphoma and other malignancies also have been reported in children and adolescents. CIMZIA is not indicated for use in pediatric patients.

*The CIMZIA Co-Pay Savings Card Program is valid for out-of-pocket expenses for CIMZIA for up to 17 uses. The CIMZIA Co-Pay Savings Card Program is not valid for prescriptions that are reimbursed, in whole or part, under Medicare (including Medicare Part D), Medicaid, similar federal or state funded programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico), private insurance in the Commonwealth of Massachusetts, or where otherwise prohibited by law. Product dispensed pursuant to program rules and federal and state laws. Claims should not be submitted to any public payor (i.e., Medicare, Medicaid, Medigap, Tricare, VA and DoD) for reimbursement. The parties reserve the right to amend or end this program at any time without notice.