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Is Your Crohn's Treatment Losing Its Power? Spotting and Tackling Infliximab Resistance

Soraya Malik in Health & Wellness December 2025 • 4 min read.

"A deep dive into infliximab resistance in Crohn's disease: what the latest research reveals about predicting and overcoming loss of response."

Crohn's disease (CD), a chronic inflammatory bowel disease (IBD), presents lifelong challenges for those affected. Characterized by diverse symptoms and impacting quality of life, CD management often involves powerful medications like infliximab (IFX). Infliximab, a monoclonal antibody targeting tumor necrosis factor-alpha (TNF-α), has revolutionized CD treatment, offering relief from inflammation and improving patient outcomes.

However, the effectiveness of infliximab can diminish over time. This phenomenon, known as loss of response (LOR), occurs when patients who initially respond well to the drug start experiencing a return of their symptoms. Understanding why LOR happens and how to predict it is crucial for optimizing treatment strategies and maintaining long-term remission.

A recent systematic review and meta-analysis has shed light on potential predictors of LOR to infliximab therapy in adults with CD. This article breaks down the study's findings, offering insights into who is most at risk and what steps can be taken to combat infliximab resistance.

What Predicts Infliximab Resistance in Crohn's Disease?

Winding road through digestive system with beam of light cutting through storm clouds

Researchers conducted a comprehensive search of English-language articles published between 1990 and March 2017, analyzing data from multiple studies to identify factors associated with LOR to infliximab. The meta-analysis consolidated data from 26 studies, encompassing 3,187 patients, to determine the rate of LOR and identify potential predictors.

The study revealed that the pooled rate of LOR to infliximab maintenance therapy, with a median follow-up of 1.05 years, was 36%. This means that over a third of patients on infliximab eventually experience a decline in its effectiveness. The analysis further pinpointed several factors that increase the risk of LOR:

Perianal Lesions: Patients with perianal lesions (sores or inflammation around the anus) were more likely to experience LOR.
Colon Involvement: CD affecting the colon was associated with a higher risk of infliximab resistance.
Younger Age at CD Onset: Individuals who developed CD at a younger age were also more prone to LOR.

Interestingly, the study also found that combination therapy with immunosuppressants (IMM) alongside infliximab was linked to a lower risk of LOR. This suggests that a multi-pronged approach to managing inflammation may improve long-term treatment outcomes.

Taking Control of Your Crohn's Journey

While the study highlights potential risk factors for infliximab resistance, it's important to remember that every patient's experience with Crohn's disease is unique. If you're concerned about losing response to infliximab, talk to your doctor. They can assess your individual risk factors, monitor your symptoms closely, and adjust your treatment plan as needed. With proactive management and open communication, you can overcome challenges and maintain a good quality of life with Crohn's disease.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/1751-2980.12698, Alternate LINK

Title: Loss Of Response To Scheduled Infliximab Therapy For Crohn'S Disease In Adults: A Systematic Review And Meta‐Analysis

Subject: Gastroenterology

Journal: Journal of Digestive Diseases

Publisher: Wiley

Authors: Qi Wei Zhang, Jun Shen, Qing Zheng, Zhi Hua Ran

Published: 2019-02-01

Everything You Need To Know

What is infliximab and why is it used in Crohn's disease treatment?

Infliximab is a monoclonal antibody that targets tumor necrosis factor-alpha (TNF-α). It's used in Crohn's disease treatment because it helps to reduce inflammation and improve outcomes for patients suffering from this chronic inflammatory bowel disease. By blocking TNF-α, infliximab helps to alleviate the symptoms and manage the disease's progression.

What does it mean when a Crohn's patient experiences a loss of response (LOR) to infliximab?

Loss of response (LOR) to infliximab occurs when a patient who initially responded well to the medication starts experiencing a return of their Crohn's disease symptoms. This indicates that infliximab is becoming less effective over time in controlling the inflammation associated with the condition. Understanding and addressing LOR is vital for maintaining long-term remission.

What factors increase the risk of developing infliximab resistance in adults with Crohn's disease?

Several factors can increase the risk of developing infliximab resistance. These include the presence of perianal lesions (sores or inflammation around the anus), colon involvement in Crohn's disease, and a younger age at the onset of the disease. Recognizing these risk factors can help doctors to proactively manage treatment strategies.

How does combination therapy with immunosuppressants affect the effectiveness of infliximab?

Combination therapy, using immunosuppressants alongside infliximab, has been linked to a lower risk of loss of response. This suggests that a multi-pronged approach to managing the inflammation in Crohn's disease can improve long-term treatment outcomes. The use of immunosuppressants may help to maintain the effectiveness of infliximab over a longer period.

If someone is experiencing a loss of response to infliximab, what steps can they take to manage their Crohn's disease?

If you're concerned about losing response to infliximab, it's important to consult with your doctor. They can assess individual risk factors, closely monitor symptoms, and adjust the treatment plan accordingly. Proactive management and open communication with a healthcare provider are crucial for overcoming challenges and maintaining a good quality of life while living with Crohn's disease. Possible adjustments may include changing the infliximab dosage, adding an immunosuppressant, or considering alternative treatment options targeting different inflammatory pathways.