Discontinuation of advanced therapy in inflammatory bowel disease: Updated evidence, guidelines, and personalized decision-making one year later

Table 1 European Crohn’s and Colitis Organization, American College of Gastroenterology and British Society of Gastroenterology summarized guidelines for advanced therapy withdrawal

Organization	Supports withdrawal?	Prerequisites	Monitoring post-withdrawal	Notes
ECCO (2023)	In patients with CD, in deep remission. Not mentioned for patients with UC.	Endoscopic + biochemical remission, ≥ 12 months	Quarterly labs, endoscopy within 6-12 months	Encourage shared decision-making
ACG (2025)	Rarely, cautious approach for patients with CD. Not mentioned for patients with UC.	Sustained deep remission, low-risk profile	Intensive follow-up, FC + CRP	Not routine; relapse risk emphasized
BSG (2024)	Yes, in selected patients with both CD and UC.	Negative FC, CRP, mucosal healing	FC quarter 2-3 months, clinical review	Suggests dose tapering over abrupt stop

ACG: American College of Gastroenterology; BSG: British Society of Gastroenterology; CD: Crohn’s disease; CRP: C-reactive protein; ECCO: European Crohn’s and Colitis Organization; FC: Fecal calprotectin; UC: Ulcerative colitis.