title: Withdrawal of anti-tumour necrosis factor α therapy in inflammatory bowel disease.
abstract: Anti-tumour necrosis factor α (anti-TNFα) therapy is an established treatment in inflammatory bowel disease. However, this treatment is associated with high costs and the possibility of severe adverse events representing a true challenge for patients, clinicians and health care systems. Consequently, a crucial question is raised namely if therapy can be stopped once remission is achieved and if so, how and in whom. Additionally, in a real-life clinical setting, discontinuation may also be considered for other reasons such as the patient's preference, pregnancy, social reasons as moving to countries or continents with less access, or different local policy or reimbursement. In contrast to initiation of anti-TNFα therapy guidelines regarding stopping of this treatment are missing. As a result, the decision of discontinuation is still a challenging aspect in the use of anti-TNFα therapy. Currently this is typically based on an estimated, case-by-case, benefit-risk ratio. This editorial is intended to provide an overview of recent data on this topic and shed light on the proposed drug withdrawal strategies.
authors.affiliation: Konstantinos Papamichael, Severine Vermeire, Department of Clinical and Experimental Medicine, Translational Research Center for Gastrointestinal Disorders, 3000 Leuven, Belgium.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Papamichael
authors.affiliation: Konstantinos Papamichael, Severine Vermeire, Department of Clinical and Experimental Medicine, Translational Research Center for Gastrointestinal Disorders, 3000 Leuven, Belgium.
authors.forename: Severine
authors.initials: S
authors.lastname: Vermeire
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D016527:Drug Costs; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000276:immunology; D017410:Practice Guidelines as Topic; D012074:Remission Induction; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000890:Anti-Infective Agents; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha
keywords: Anti-tumour necrosis factor α therapy; Inflammatory bowel disease; Infliximab; Remission; Withdrawal