De-escalation of Immunomodulators and Biological Agents in Inflammatory Bowel Disease / 胃肠病学

ABSTRACT

Immunomodulators and biological agents are widely used in inflammatory bowel disease (IBD), and induce remission effectively. However, these drugs are related to serious adverse events, and coupled with increasing treatment costs. Therefore, once patients with IBD are in remission, the safety and feasibility of drug de-escalation should be considered, and the risk of continuing medical therapy against the risk of disease relapse must be weighed. This review article analyzed the published literatures on de-escalation of immunomodulators and biological agents in patients with Crohn's disease and ulcerative colitis, identifying the risk factors of relapse after drug withdrawal, such as disease activity, prognostic features and previous disease course, and discussed the strategies for de-escalation and use of proactive therapeutic drug monitoring, so as to provide some guidance for clinical practice.