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©The Author(s) 2023.
World J Clin Cases. Apr 26, 2023; 11(12): 2657-2669
Published online Apr 26, 2023. doi: 10.12998/wjcc.v11.i12.2657
Published online Apr 26, 2023. doi: 10.12998/wjcc.v11.i12.2657
Table 2 Summary of the available evidence for withdrawal of immunosoppressive drugs in inflammatory bowel disease
Drug | Minimum therapy duration before withdrawal, yr | Estimated risk of disease relapse after withdrawal | Therapeutic drug monitoring before withdrawal | Estimated efficacy of re-treatment | De-escalation |
Immunomodulators (thiopurine in CD/UC or methotrexate in CD) | 3-5 | 30% by 2, 50%–75% by 5 yr | No data available | 75%-90% (often in combination with steroids) | Possible in combination therapy |
Anti-TNF | 1-2 | 30%–40% at 6 mo/1 year and > 50% by 2 yr | Possible | 80%-90% | Possible (TDM suggested) |
Vedolizumab | No data available | 65% by 1.5 yr | No data available | 50%-65% | No IBD data available beyond 8 wk |
Ustekinumab | No data available | 59.5% by 1 yr in registrative studies | No data available | 39.2%-64% in registrative studies | No IBD data available beyond 12 wk |
Tofacitinib | No data available | 65 % by 6 mo, 80 % by 1 yr in registrative studies | No data available | 75% after 2 months and 50 % after 3 yr in registrative studies | No IBD data available for dosage < 5 mg bid |
- Citation: Crispino F, Michielan A, Grova M, Tieppo C, Mazza M, Rogger TM, Armelao F. Exit strategies in inflammatory bowel disease: Looking beyond anti-tumor necrosis factors. World J Clin Cases 2023; 11(12): 2657-2669
- URL: https://www.wjgnet.com/2307-8960/full/v11/i12/2657.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v11.i12.2657