DOI: https://doi.org/10.36347/sjams.2026.v14i03.001

Pages: 322-326

Anti–tumor necrosis factor (anti-TNF) agents have markedly improved the management of Crohn’s disease (CD); however, a substantial proportion of patients experience primary non-response (PNR) or secondary loss of response (SLR), limiting long-term treatment efficacy. This retrospective descriptive and analytical study included 71 patients with CD treated with anti-TNF therapy to determine the rate of therapeutic failure and identify predictive factors. Treatment failure was defined as absence of clinical improvement at week 14 for infliximab and week 8 for adalimumab (primary non-response), or secondary loss of response during follow-up confirmed by clinical, biological, endoscopic, or radiological assessment. Primary non-response occurred in 16.9% of patients, while 52.1% developed secondary loss of response, leaving only 31% with sustained response to the initial biologic therapy. Multivariate logistic regression analysis identified low body mass index (OR = 0.045, p = 0.003) and elevated platelet count (OR = 1.0000, p = 0.004) as independent predictors of anti-TNF failure. These findings highlight the high frequency of therapeutic failure in CD and underscore the importance of early identification of predictive factors to optimize personalized and pharmacokinetically guided treatment strategies.