Biologic Loss of Response IBD — RACP Adult Medicine MCQ

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ModerateGastroenterology & HepatologyBiologic Loss of Response IBDRACP Adult Medicine

A 62-year-old man with Crohn's on vedolizumab develops secondary loss of response (adequate trough levels, no anti-drug antibodies). Next step?

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Correct answer: D — Switch out of class (anti-TNF, ustekinumab, or risankizumab)

Pharmacodynamic failure (adequate levels, no antibodies): switch to different mechanism (out-of-class switch). In-class switch not effective for pharmacodynamic failure.

Reference: eTG – 2025 – Gastrointestinal; ECCO – 2024