Withdrawal of anti-tumour necrosis factor α therapy in inflammatory bowel disease

Figure 1 New concept of intermittent anti-tumor necrosis factor α therapy in inflammatory bowel disease. Stopping anti-TNFα agents after achieving a deep remission may result in prolonged clinical remission. Close monitoring of these patients with fecal calprotectin and CRP measurements (arrows) will allow early re-initiation of anti-TNFα therapy, when inflammation is starting to rise, which may result to a sustained clinical benefit (dotted line) preventing a disease flare (red cross). These patients may be considered as treated periodically and not episodically. TNF: Tumor necrosis factor; CRP: C-reactive protein.