Optimal Endpoint of Therapy in IBD: An Update on Factors Determining a Successful Drug Withdrawal
Ulcerative colitis (UC) and Crohn’s disease (CD) are chronic inflammatory disorders, which require long term treatment to achieve remission and to prevent relapses and cancer. While current therapies are effective in most cases, they can have rare but serious side effects and are often associated wi...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2015/832395 |
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| author | Anita Annaházi Tamás Molnár |
| author_facet | Anita Annaházi Tamás Molnár |
| author_sort | Anita Annaházi |
| collection | DOAJ |
| description | Ulcerative colitis (UC) and Crohn’s disease (CD) are chronic inflammatory disorders, which require long term treatment to achieve remission and to prevent relapses and cancer. While current therapies are effective in most cases, they can have rare but serious side effects and are often associated with high costs. On the other hand, early discontinuation of an effective treatment may lead to a quick relapse and to complications at the restart of therapy. Therefore it is essential to determine the optimal duration of maintenance therapy, but clear guidelines are missing. The most important questions when deciding whether to continue or withdraw therapy in quiescent UC and CD patients are the efficacy of the continuous treatment to maintain remission in the long term, the frequency and severity of side effects, and the chance of relapse after discontinuation of therapy. This review summarizes the current knowledge on these topics with respect to 5-aminosalicylates, thiopurines, methotrexate, and biological therapies and collects information regarding when and in which specific patient groups, in the absence of risk factors, can withdrawal of therapy be considered without a high risk of relapse. Additionally, the particular aspect of colorectal cancer prevention by current therapies will also be discussed. |
| format | Article |
| id | doaj-art-596578dac4604641b42577801bc4c25a |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-596578dac4604641b42577801bc4c25a2025-02-03T01:11:47ZengWileyGastroenterology Research and Practice1687-61211687-630X2015-01-01201510.1155/2015/832395832395Optimal Endpoint of Therapy in IBD: An Update on Factors Determining a Successful Drug WithdrawalAnita Annaházi0Tamás Molnár1First Department of Medicine, University of Szeged, Szeged 6720, HungaryFirst Department of Medicine, University of Szeged, Szeged 6720, HungaryUlcerative colitis (UC) and Crohn’s disease (CD) are chronic inflammatory disorders, which require long term treatment to achieve remission and to prevent relapses and cancer. While current therapies are effective in most cases, they can have rare but serious side effects and are often associated with high costs. On the other hand, early discontinuation of an effective treatment may lead to a quick relapse and to complications at the restart of therapy. Therefore it is essential to determine the optimal duration of maintenance therapy, but clear guidelines are missing. The most important questions when deciding whether to continue or withdraw therapy in quiescent UC and CD patients are the efficacy of the continuous treatment to maintain remission in the long term, the frequency and severity of side effects, and the chance of relapse after discontinuation of therapy. This review summarizes the current knowledge on these topics with respect to 5-aminosalicylates, thiopurines, methotrexate, and biological therapies and collects information regarding when and in which specific patient groups, in the absence of risk factors, can withdrawal of therapy be considered without a high risk of relapse. Additionally, the particular aspect of colorectal cancer prevention by current therapies will also be discussed.http://dx.doi.org/10.1155/2015/832395 |
| spellingShingle | Anita Annaházi Tamás Molnár Optimal Endpoint of Therapy in IBD: An Update on Factors Determining a Successful Drug Withdrawal Gastroenterology Research and Practice |
| title | Optimal Endpoint of Therapy in IBD: An Update on Factors Determining a Successful Drug Withdrawal |
| title_full | Optimal Endpoint of Therapy in IBD: An Update on Factors Determining a Successful Drug Withdrawal |
| title_fullStr | Optimal Endpoint of Therapy in IBD: An Update on Factors Determining a Successful Drug Withdrawal |
| title_full_unstemmed | Optimal Endpoint of Therapy in IBD: An Update on Factors Determining a Successful Drug Withdrawal |
| title_short | Optimal Endpoint of Therapy in IBD: An Update on Factors Determining a Successful Drug Withdrawal |
| title_sort | optimal endpoint of therapy in ibd an update on factors determining a successful drug withdrawal |
| url | http://dx.doi.org/10.1155/2015/832395 |
| work_keys_str_mv | AT anitaannahazi optimalendpointoftherapyinibdanupdateonfactorsdeterminingasuccessfuldrugwithdrawal AT tamasmolnar optimalendpointoftherapyinibdanupdateonfactorsdeterminingasuccessfuldrugwithdrawal |