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Current Gastroenterology Reports
Erschienen in: Current Gastroenterology Reports 8/2018

01.08.2018 | Inflammatory Bowel Disease (S Hanauer, Section Editor)

De-escalation of Therapy in Inflammatory Bowel Disease

verfasst von: Catarina Frias Gomes, Jean-Frédéric Colombel, Joana Torres

Erschienen in: Current Gastroenterology Reports | Ausgabe 8/2018

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Abstract

Purpose of Review

Currently, inflammatory bowel disease treatment is based on immunomodulators (IM) and/or biologic as this strategy may prevent the development of irreversible damage. Nevertheless, long-term treatment may be associated with non-negligible side effects and with high costs, and therefore the question on whether therapy can be de-escalated is often posed in clinical practice.

Recent Findings

Recent studies have shown a predictable rate of relapse after stop biologic or IM therapy withdrawal. Overall, around 40–50% of patients will eventually relapse over the following year after drug withdrawal, and the rates will increase over time. Stratification of patients and therapeutic drug monitoring could be promising alternatives to guide therapeutic management.

Summary

We reviewed the current evidence on de-escalation strategy and summarised the recent results on discontinuation and dose reduction. Nowadays, de-escalation strategy is still a case-by-case decision in highly selected patients.
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Metadaten
Titel
De-escalation of Therapy in Inflammatory Bowel Disease
verfasst von
Catarina Frias Gomes
Jean-Frédéric Colombel
Joana Torres
Publikationsdatum
01.08.2018
Verlag
Springer US
Erschienen in
Current Gastroenterology Reports / Ausgabe 8/2018
Print ISSN: 1522-8037
Elektronische ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-018-0643-8

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