Crohn's Disease

What is Anti-TNF for Crohn's?

Infliximab and adalimumab block tumor necrosis factor alpha, a key driver of intestinal inflammation in Crohn's disease. With therapeutic drug monitoring, they achieve deep remission and mucosal healing — the modern treatment target.

Why China?

• Cost (annual): $4,000-$8,000 (domestic infliximab biosimilar) vs. $30,000-$45,000 in the US
• Biosimilars approved: CT-P13, adalimumab biosimilars widely available
• TDM standard: Therapeutic drug monitoring reduces failure/optimizes dose
• IBD expertise: Xinhua Hospital, Zhongshan, PUMC — dedicated IBD centers

Who is a candidate?

• Moderate-severe Crohn's disease
• Steroid-dependent or steroid-refractory
• Fistulizing disease
• Perianal disease
• Failed conventional immunomodulators

Outcomes

Clinical response at 1 year: 55-65%. Steroid-free remission: 40-50%. Endoscopic healing: 30-40%. Combined with immunomodulator: better durability. Loss of response: ~30% at 5 years (switch to ustekinumab or vedolizumab).