Key Points:
- A population-based observational study revealed that approximately two-thirds of Crohn’s disease patients who initially responded to anti-TNF therapy lost their treatment response by the third year. Specifically, 60% on infliximab and 68% on adalimumab experienced this decline.
- Higher concentrations of anti-TNF agents at the end of the induction period significantly lowered the risk of losing treatment response. Each 10-fold increase in drug concentration reduced the risk by 55% for infliximab and 61% for adalimumab.
- Female sex, obesity, and specific genetic markers like the HLA-DQA1*05 risk variant were associated with a higher risk of losing treatment response. Additionally, the use of thiopurines influenced treatment effectiveness, where higher doses were linked to better maintenance of response.
- Concomitant use of immunomodulatory agents during initial treatment reduced the risk of developing immunity to anti-TNF drugs.