De-escalation of medical therapy in inflammatory bowel disease.
Curr Opin Pharmacol
; 55: 73-81, 2020 12.
Article
in English
| MEDLINE | ID: covidwho-908964
ABSTRACT
Treatment strategies for inflammatory bowel disease (IBD) now increasingly target deep remission, yet the resultant more aggressive use of medical therapy is associated with potentially serious adverse events and significant costs. It is, therefore, of vital importance to consider when, how and in whom medical therapy may be safely de-escalated. This issue is of great potential relevance in the current SARS-Cov-2 pandemic. In this review, we first discuss the rationale for drug withdrawal in IBD, before considering the available data on withdrawal of 5-aminosalicylates (5-ASA), immunomodulators (IM) and biological therapy in both ulcerative colitis (UC) and Crohn's Disease (CD). We consider how to identify patients most appropriate for drug withdrawal and outline a potential monitoring strategy for the early detection of relapse following drug withdrawal. We conclude with important future perspectives in this challenging field, and highlight ongoing trials that are likely to shape practice in the years to come.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Biological Therapy
/
Inflammatory Bowel Diseases
/
Mesalamine
/
Safety-Based Drug Withdrawals
/
Immunologic Factors
Limits:
Humans
Language:
English
Journal:
Curr Opin Pharmacol
Journal subject:
Pharmacology
Year:
2020
Document Type:
Article
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