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World J Clin Cases. Apr 6, 2024; 12(10): 1718-1727
Published online Apr 6, 2024. doi: 10.12998/wjcc.v12.i10.1718
Discontinuation of therapy in inflammatory bowel disease: Current views
Antonio Meštrović, Marko Kumric, Josko Bozic
Antonio Meštrović, Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
Marko Kumric, Josko Bozic, Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
Author contributions: Meštrović A, Kumric M and Bozic J wrote the manuscript. All authors have read and approve the final manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Josko Bozic, MD, PhD, Associate Professor, Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, Split 21000, Croatia. josko.bozic@mefst.hr
Received: December 31, 2023
Peer-review started: December 31, 2023
First decision: January 9, 2024
Revised: February 25, 2024
Accepted: March 14, 2024
Article in press: March 14, 2024
Published online: April 6, 2024
Processing time: 92 Days and 15.3 Hours
Core Tip

Core Tip: Tailoring treatment for inflammatory bowel disease (IBD) hinges on timely drug initiation aligned with treatment objectives. While therapy approaches evolve, achieving and sustaining remission prompts discussions on de-escalating or halting treatment, weighed against long-term therapy risks. With each IBD drug category, relapse risks persist post-discontinuation, impacting over 50% of patients. Withdrawal following combination therapies shows prolonged relapse-free periods, yet randomized trials on medication cessation are limited. Identifying relapse predictors and suitable candidates is pivotal. Re-treatment success underpins therapy withdrawal decisions. Individualized assessments, considering disease severity, duration, side effects, relapse risk, and patient preferences all guide prudent discontinuation choices.