A User's Guide to De-escalating Immunomodulator and Biologic Therapy in Inflammatory Bowel Disease

被引：9

作者：

Hirten, Robert P. ^{[1
]}

Lakatos, Peter L. ^{[2
,3
]}

Halfvarson, Jonas ^{[4
]}

Colombel, Jean Frederic ^{[1
]}

机构：

[1] Icahn Sch Med Mt Sinai, Div Gastroenterol, 1 Gustave L Levy Pl, New York, NY 10029 USA

[2] McGill Univ, Hlth Ctr, Div Gastroenterol, Montreal, PQ, Canada

[3] Semmelweis Univ, Dept Med 1, Budapest, Hungary

[4] Orebro Univ, Fac Med & Hlth, Dept Gastroenterol, Orebro, Sweden

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2020年 / 18卷 / 06期

基金：

欧盟地平线“2020”;

关键词：

Crohn's Disease; Ulcerative Colitis; Deescalation; Withdrawal; Cessation; Treatment Discontinuation; SUSTAINED CLINICAL REMISSION; ANTI-TNF DISCONTINUATION; LONG-TERM REMISSION; CROHNS-DISEASE; MAINTENANCE TREATMENT; ULCERATIVE-COLITIS; AZATHIOPRINE WITHDRAWAL; FECAL CALPROTECTIN; RISK-FACTORS; FOLLOW-UP;

D O I：

10.1016/j.cgh.2019.12.019

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

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.

引用

页码：1336 / 1345

页数：10

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