It’s estimated that a little over a million Americans are living with Crohn’s disease. While the autoimmune condition can be treated in different ways, a recent market analysis noted that the use of biologics is growing. In 2025, 65 percent of Americans with moderate to severe Crohn’s disease opted to use biologics to manage their condition. The analysis also suggests that the number of people who use biologics may also continue to grow. With that in mind, it’s important to know what questions Black people need to ask about this form of treatment.
Crohn’s disease is a chronic autoimmune condition in which your immune system malfunctions and starts to attack your digestive system. As a result, the area becomes inflamed, and you can experience various symptoms. While you may not have all of these issues, common symptoms include stomach cramps, diarrhea, chronic fatigue, unexplained fever, loss of appetite, unexpected weight loss, blood in your stool, and mouth sores.
Although Crohn’s disease can’t be cured, your doctor can prescribe medication to manage your symptoms and prevent painful flare-ups. The type of medication you receive can be determined by factors like the severity of your symptoms, the part of your digestive tract that’s being affected, and how you respond to medication. In any case, the medications are generally meant to reduce inflammation and your risk of complications from the condition.
When it comes to medication, you may take antibiotics, corticosteroids, immunomodulators, JAK inhibitors, or biologics. Antibiotics are meant to kill harmful bacteria, and corticosteroids reduce inflammation. Immunomodulators soothe the immune system, and JAK inhibitors suppress the immune system’s activity. Biologics, however, are a type of targeted therapy that targets specific components of the immune system that usually cause inflammation.
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Biologics typically work by targeting the proteins your immune system produces that cause inflammation. These drugs are made from living cells that can block the action of specific proteins in your body. By using these targeted methods, doctors can more directly curb the problems causing your symptoms. Your doctor is most likely to prescribe biologics if your symptoms are moderate to severe or if your condition hasn’t responded to any other medication.
Currently, there are three types of biologics that can be prescribed to you. The first are called tumor necrosis factor (TNF) blockers. TNF is a strong signaling protein that helps the immune system communicate with the rest of the body. When it’s in effect, your body increases the immune system’s activity, resulting in inflammation. TNF blockers bind to this protein and prevent it from binding to the cells that could receive its signal.
The second are integrin blockers. Integrins are also proteins, but they function differently from the TNF. These proteins can be found on the surfaces of different cells, and they help cells attach to each other or to various parts of the body. White blood cells commonly use integrins to slow down and bind to the inner lining of blood vessels, allowing them to enter tissues. It’s also one way immune cells can reach areas of the body where they’re needed.
With Crohn’s disease, though, integrins can give inflammatory white blood cells a route to travel from the bloodstream and into the intestinal wall. Once this happens, they can add to existing inflammation. Using an integrin blocker reduces the number of available integrins for white blood cells to bind to, which can reduce inflammation while giving your intestinal lining time to heal.
The third option is a class of drugs known as interleukin blockers. Interleukin-12 and interleukin-23 are immune signaling proteins that help with the immune system’s communication and coordination of the body’s defenses. The proteins kick specific white blood cells into gear while signaling that inflammation is needed. When you’re dealing with Crohn’s disease, these proteins can be too active and lead to increased inflammation in the digestive tract. By taking interleukin blockers, you prevent the proteins from attaching themselves to other cells, so there are fewer signals for inflammation.
If you’ve been prescribed a biologic, you may receive it as an IV infusion or an injection. Although it may take a few weeks for the effects to become apparent, you must continue using it. Because biologics work by stimulating the body’s immune response, you risk your body developing antibodies against the medicine, which can make it ineffective.
Apart from reducing your symptoms, biologics can have effects that would be most beneficial for Black people. They can heal the intestinal lining, lower your risk of being hospitalized, help to heal fistulas, depending on the drug you’ve been prescribed, lengthen the time between flare-ups, and increase your quality of life.
These benefits are notable because, according to one study, Black people are more likely to develop the penetrative phenotype form of Crohn’s disease. This form of the condition is associated with a higher likelihood of fistulas, perianal ulcers, inflammatory masses, or abscesses. In another study, researchers found that patients with penetrative phenotype Crohn’s disease report having a harder time managing the condition and are more likely to have the illness progress to the point of needing surgery. The study suggested that using medication to manage Crohn’s disease in these people may stop its progression to such a severe stage.
Of course, as you may expect, biologics may have some side effects. The specific issues may depend on which drugs you’re taking, so it’s important to discuss them with your doctor. Some possible side effects include rash, swelling at the injection site, joint pain, an increased risk of certain infections, nausea, stomach pain, headaches, back pain, chronic fatigue, and anemia.
In some cases, you may need to avoid other medications–including biologics–when taking certain courses of treatment.
The discussion about your treatment options may start as soon as your doctor has diagnosed you with Crohn’s disease and determined whether your condition is mild, moderate, or severe. When it’s time to talk about biologics, there are a few important questions that you should ask. These include:
It’s important to note, though, that this is just a guide to getting the information you need. You can certainly add more questions based on your doctor’s answers.
Many people with moderate to severe forms of Crohn’s disease opt to manage their condition with biologics. While these medications can be life-changing, you still need to know what you’re getting into. That’s why you should ask a lot of questions and learn everything you can.
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