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A Users Guide to De-escalating Immunomodulator and Biologic Therapy in Inflammatory Bowel Disease

Hirten, Robert P. (author)
The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York NY, USA
Lakatos, Peter L. (author)
Division of Gastroenterology, McGill University Health Centre Montreal Canada; 1st Department of Medicine Semmelweis University Budapest, Hungary
Halfvarson, Jonas, 1970- (author)
Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology
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Colombel, Jean Frederic (author)
The Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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The Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York NY, USA Division of Gastroenterology, McGill University Health Centre Montreal Canada; 1st Department of Medicine Semmelweis University Budapest, Hungary (creator_code:org_t)
Elsevier, 2020
2020
English.
In: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 18:6, s. 1336-1345
  • Research review (peer-reviewed)
Abstract Subject headings
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  • De-escalation of immunomodulators and biologic agents in inflammatory bowel disease is frequently discussed with patients and must weigh the risk of continued medical therapy with the risk of disease recurrence. Risk factors for disease flare after withdrawal of inflammatory bowel disease medications such as disease activity at de-escalation, disease prognostic features and prior course of disease have been identified predominately in retrospective studies allowing for risk stratification of patients. This review evaluates the published literature regarding therapeutic de-escalation and provides a framework for physicians to apply this to clinical practice. Prospective trials are underway and planned which should provide further insight into this treatment paradigm and better inform patient selection for this strategy.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

Keyword

Crohn's Disease
Ulcerative Colitis
Deescalation
Withdrawal
Cessation
Treatment Discontinuation

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Örebro University

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