Your doctor will consider your age as well as whether you have any other health conditions. For example, you won’t receive an anti-TNF biologic if you’ve had heart failure (they’re contraindicated). And, something to know about people already on biologics: Remicade was the first available on the market for Crohn’s disease, in the late 1990s, so if a patient you know has been on it for years, that could be why.
But other than these factors? A lot isn’t yet known about which biologic might be best for you, according to experts. “We would love some good predictors to say, based on this patient’s genetic makeup, their inflammatory burden, you name it, they’re going to respond better to drug X rather than drug Y. They don’t really exist yet, at least as far as clinical practice,” says Dr. Ehrlich.