Stopping Anti-TNF in Crohn’s Disease Remitters: Pros and Cons: The Pros

Background: There is no cure for Crohn’s disease (CD). Available treatments and treatment strategies, particularly anti-TNF, allow healing intestinal lesions and maintaining steroid-free remission in a subset of patients. Having in mind the remitting/relapsing nature of the disease, patients and health care providers often ask themselves whether the treatment could be withdrawn. Several studies have demonstrated a risk of relapse of CD after anti-TNF withdrawal, which varies from 20 to 50% at 1 year and from 50 to 80% beyond 5 years. These numbers clearly highlight that stopping therapy should not be a systematically proposed strategy in those remitting patients. Summary: Nobody would argue for anti-TNF withdrawal in patients with a high risk of short-term relapse. Nevertheless, they also indicate that a minority of patients may not relapse over midterm and that those who have relapsed may have benefited from a drug-free period before being again treated for a new cycle of treatment. The most relevant question is thus whether in those patients with a low to medium risk of disease relapse, treatment withdrawal could be contemplated. In this specific setting, there may be pros and cons for anti-TNF withdrawal. Among the pros are the potential side effects and toxicity of anti-TNF, the risk of loss of response over time, the patient preference allowing the patient to regain control of one’s health and investing in it, also improving adherence, the absence of a negative impact on disease evolution of a transient anti-TNF withdrawal, and finally the cost. Key Messages: Although anti-TNF withdrawal in patients with sustained clinical remission is associated with a high risk of relapse, this risk seems to be much lower in a subgroup of patients, particularly in endoscopic and biologic remission. Stopping anti-TNF in this subgroup of patients may be associated with a favorable benefit/risk ratio.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Stopping Anti-TNF in Crohn’s Disease Remitters: Pros and Cons: The Pros ; volume:7 ; number:1 ; year:2021 ; pages:64-68 ; extent:5 ; Inflammatory intestinal diseases ; 7, Heft 1 (2021), 64-68 (gesamt 5)

Contributors, Places and Time

• Creator: Louis, Edouard

Further information

• DOI: 10.1159/000520942
• URN: urn:nbn:de:101:1-2022012623302947367350
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:24 AM CEST