It's true that biologics can wear off, but two counterpoints: (1) with the wealth of options available on the market today, you can generally hop to a new drug if a particular formulation starts losing its effectiveness, and (2) even if you only got Three Glorious Years of relief before all biologics stopped working for you forever, isn't that still a net gain versus not going on them at all?

For what it's worth, though, many people don't develop resistance, or at least not for a loooong time. My gastro told me one patient of his has been on Remicade for 15+ years and it's put them in happy remission the whole time.

Not everyone's a success story, but the success stories are very very good.

I've been on adalimumab since I was 19, I'm 34 now. Treatment for Crohn's disease. I've had the talk with my doctors multiple times about what we do if the treatment stops working, and they always reassure me that there's multiple other options these days.

> many people don't develop resistance, or at least not for a loooong time

Yes, but I have also seen people who used biologics for 10 years without issue, and out of the blue they started to have severe side effects that made them move drop off (or move to another one). You just never know.