W El-Matary et al. JPGN 2020; 71: 740-743. Discontinuation of Immunosuppressive Medications in Children With Inflammatory Bowel Disease on Combination Therapy

This study looked at 105 patients receiving combination therapy; the a median duration of combination therapy was 2.1 years, with infliximab and either methotrexate  (53) or azathioprine (52). 89 patients had Crohn’s disease.

Key findings:

• 11 (10.5%) patients experienced a clinical relapse over a median duration of follow-up of 12.0 months after stopping the immunomodulator.
• In the patients who did not relapse, the median IFX trough level at IM discontinuation was 6.2; the IFX trough level was 3.8 μg/mL in those who relapsed.

In their discussion, the authors urge caution in discontinuation of immunomodulators in those with clinically-severe Crohn’s disease and those with low infliximab levels.

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• Proactive Therapeutic Drug Monitoring in Pediatric Crohn’s disease -Better Outcomes | gutsandgrowth
• Combination Therapy Associated with Treatment Persistence | gutsandgrowth
• Changes in the Use of IBD Biologic Therapy | gutsandgrowth
• Should All Pediatric Patients with Crohn’s Disease Continue Combination Therapy? | gutsandgrowth
• Don’t be Fooled About Withdrawing Immunomodulator Cotherapy -Look Past the Headline

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