Mucosal healing in inflammatory bowel disease: Maintain or de-escalate therapy

Table 4 Synopsis on relapse rates with or without withdrawal of immunomodulator or biologics

Drugs	Overall patients number	Relapse at 1 yr	Relapse at 2 yr	Relapse at 5 yr
Immunomodulator	659 CD, 744 UC
Maintenance	Mixed	6%	10%[65]	48%[65]
Median (range)		(range 5-43)[65-67]
	Only CD	6%[67]
	Only UC	43%[66]
De-escalation	Mixed	20.50%	44%	63.50%
Median (range)		(range 12-37)[65,68-71]	(range 25-56)[65,68,70]	(range 43-75)[65,68-71]
	Only CD	18%	39%[70]	62%[69]
		(range 14-22)[69,70]
	Only UC	19%	37%	54%
		(range 12-35)[68,70,71]	(range 25-49)[68,70]	(range 43-65)[68,71]
Anti-TNF	605 CD, 216 UC
Maintenance	Mixed	49%	72%
Median (range)		(range 23-75)[58,95]	(range 36-83)[58,73,95]
	Only CD	75%[95]	77.5%[73,95]
			(range 72-83)
	Only UC	23%[58]	36%[58]
De-escalation	Mixed	35%	48.5%	46%
Median (range)		(range 4-45)[76-80,82,84-86]	(range 7-80)[76,84-86]	(range 27-65)[84,86]
	Only CD	37.5%	48.50%	46%
		(range 4-45)[76,77,80,84-86]	(range 7-80)[76,84-86]	(range 27-65)[84,86]
	Only UC	30% (range 25-35)[76,78]	60%[76]
Combination therapy	362 CD
Anti-TNF de-escalation	262 CD	31%	50%
		(range 30-44)[75,81,88]	(range 48-52)[75,81]
Immunomodulator de- escalation	100 CD	20%[88]	58%[73]

UC: Ulcerative colitis; CD: Crohn’s disease.