By Dr. Pranab Gyawali — UK-Trained Consultant Gastroenterologist, Dubai
How Doctors Predict Biologic Success in Crohn’s Disease & Ulcerative Colitis
Introduction
If you are about to start infliximab — whether that is Remicade®, Inflectra®, Remsima®, Flixabi®, or Ixifi® — it is natural to ask:
“Is this actually going to work for me?”
As a UK-trained gastroenterologist in Dubai, I discuss this question regularly with patients starting biologic therapy for Crohn’s disease or ulcerative colitis.
This article explains how doctors think about infliximab success using three objective checks available today, and one emerging marker that may influence future treatment decisions.
What is infliximab and which brands are used in Dubai?
Infliximab is an anti-TNF biologic used to treat moderate to severe inflammatory bowel disease. In Dubai, it is prescribed under several trade names:
- Remicade®
- Inflectra®
- Remsima®
- Flixabi®
- Ixifi® (often heard as “Xifi”)
These are biosimilars. The predictors of success are the same regardless of brand.
The three checks doctors use now
1. Smoking status
Smoking is one of the strongest predictors of anti-TNF failure in Crohn’s disease. Stopping smoking is one of the few modifiable factors that can improve biologic outcomes.
2. Albumin (blood protein level)
Low albumin reflects higher inflammatory burden. When albumin is low, infliximab is cleared faster, which may require dose or schedule optimisation.
3. HLA-DQA1*05 genetic marker
This genetic marker is associated with higher risk of antibody formation against infliximab, which can reduce effectiveness across all biosimilars.
What if infliximab does not work?
If infliximab does not work, it usually means inflammation is driven by a different immune pathway — not that treatment options are exhausted.
Oncostatin-M: what’s coming next?
Oncostatin-M is an inflammatory signalling protein. High activity has been associated with reduced response to anti-TNF drugs in research studies. This is not yet a routine test, but may help guide future biologic selection.
Recommended Guides
- Ulcerative Colitis in Dubai
- Crohn’s Disease in Dubai
- IBD Treatment Update 2026: What’s Changing for Crohn’s & Colitis Patients in Dubai
- How 5-ASA Works in Ulcerative Colitis (Salofalk, Pentasa, Asacol)
- Learn about Biologicals used in UC and Crohn’s in Dubai
- Inflammatory Bowel Disease (IBD)
Related IBD VLOGs
- How Biologics Work in Crohn’s and Colitis
- Feeling Fine Isn’t Enough—Is Your Gut Really Healed?
- Diet, Microbiome & IBD: How the Right Bacteria Calm Gut Inflammation
- Protect Your Gut: 3 Foods to Avoid in Crohn’s & Colitis
- SIBO in Crohn’s & UC — The Overlooked Gut Issue You Shouldn’t Ignore
- Leaky Gut in Crohn’s & UC: What It Really Means
- Stress and Crohn’s & Colitis — Why the Gut–Brain Connection Matters
- Sleep & Gut Health: Why 6–8 Hours Matters (Dubai)
- Brain–Gut Connection: How Your Gut and Mind Affect Each Other
- Iron Deficiency & Anaemia in Crohn’s & UC
- B12 and Folate Deficiency in Crohn’s & UC
- Flu Season in Dubai: Vaccines for IBD Patients on Biologics
- What Can I Eat If I Have IBD? (Dubai)
Investigations & Procedures
- Colonoscopy
- Gastroscopy / Upper GI Endoscopy
- CT Abdomen and Pelvis
- MRI Abdomen (including MR Enterography)
- Hydrogen & Methane Breath Test (SIBO)
- Capsule Endoscopy
- Gut Microbiome (general)
- Gut Microbiome in Crohn’s & UC
If you wish to discuss this further, please use the booking form on this page. A member of our team will contact you within 12 business hours.