Black Inflammatory Bowel Disease Patients Have Lower Response to Antitumor Necrosis Factor Agents Compared With White Patients

Inflamm Bowel Dis. 2023 Dec 5;29(12):1847-1853. doi: 10.1093/ibd/izad005.


Background: Most studies on the safety and efficacy of antitumor necrosis factor alpha (anti-TNF) agents in the treatment of inflammatory bowel disease have included few Black patients.

Aims: We aimed to evaluate the therapeutic response rate in Black IBD patients compared with White patients.

Methods: We conducted a retrospective review of IBD patients who were treated with anti-TNF agents and assessed those with therapeutic drug levels for clinical, endoscopic, and radiologic response to anti-TNF treatment.

Results: We identified 118 patients who met the inclusion criteria. Black IBD patients had significantly higher prevalence of endoscopic and radiologic active disease compared with White patients (62% and 34%, respectively; P = .023), despite similar proportions reaching therapeutic titers (67% and 55%, respectively; P = .20). Moreover, Black patients had significantly higher rate of IBD-related hospitalizations than White patients (30% vs 13%, respectively; P = .025) while on anti-TNF agents.

Conclusions: Black IBD patients on anti-TNF agents had a significantly higher prevalence of active disease and more IBD-related hospitalizations than White patients.

Plain language summary

This study explores the question of how IBD therapeutic efficacy may vary among racial groups.

MeSH terms

  • Black or African American
  • Humans
  • Inflammatory Bowel Diseases* / drug therapy
  • Inflammatory Bowel Diseases* / epidemiology
  • Retrospective Studies
  • Tumor Necrosis Factor Inhibitors* / therapeutic use
  • White


  • Tumor Necrosis Factor Inhibitors