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1.8 – Case Study: When the Body

Turns on the Drug

In 2019, a young woman with terminal ileal Crohn’s
disease, a form of Crohn’s disease which attacks the final
section of the small intestine, began treatment with
infliximab—better known by its brand name, Remicade.
Like many living with inflammatory bowel disease, she had
already cycled through years of vague symptoms, failed
medications, and specialist visits. When Remicade was
prescribed—alongside Purixan, an immunosuppressant—it
felt like hope finally had structure.

And for a time, it worked. Her pain eased. Inflammation
dropped. She returned to work. Traveled again.
Reconnected with parts of her life that had been on hold for
years. A drug had finally done what years of interventions
had failed to do—it gave her a glimpse of stability.

But then, slowly, the foundation began to crack.

The symptoms crept back. Not as a sudden flare, but as a
gradual unraveling—days of fatigue, gut discomfort, and
the quiet fear that the disease was no longer under control.
Her lab work reflected the same uncertainty. In search of
clarity, her doctor ordered ADA testing.

The results were decisive: her immune system had begun
producing antibodies against Remicade. What was once
medicine was now, in her body’s eyes, a threat.

This wasn’t noncompliance. It wasn’t progression of
disease. It was tolerization—a biologic drug being
gradually neutralized by the very immune system it was

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