Exit strategies in inflammatory bowel disease: Looking beyond anti-tumor necrosis factors

Table 1 Predictive factors for disease recurrence after therapy withdrawal

Poor disease prognostic features	CD/UC: Young age at diagnosis and male sex
	CD: Ileal, colonic or perianal disease; stricturing/penetrating disease
	UC: Pancolitis
Challenging disease control before withdrawal	Many relapses requiring add-on steroids
	Anti-TNF escalation while already on
	Need for surgery or anti-TNF post-operative prophylaxis
Biochemical disease activity	High CRP levels
	Elevated fecal calprotectin
	Elevated white cells or neutrophil count
	Low hemoglobin levels
Endoscopic disease activity	No mucosal healing
Radiological CD activity	No transmural healing
IFX trough levels	High IFX trough levels in monotherapy
	Low IFX trough levels in combination therapy with an imunomodulator

CD: Crohn’s disease; UC: Ulcerative colitis; TNF: Tumor necrosis factor; CRP: C-reactive protein; IFX: Infliximab.