Curbside Consultation in IBD: 49 Clinical Questions, Second Edition

David T Rubin, MD; Sonia Friedman, MD; Francis A Farraye, MD MSc

Question 22: Is It Ever Appropriate To Stop Anti-Tumor Necrosis Factor In A Stable Patient? (continued)

Edouard Louis, MD, PhD

The inflammatory bowel diseases (IBDs) are chronic relapsing inflammatory disorders of the gastrointestinal tract with a propensity to develop tissue damage—including fibrosis and strictures—penetrating lesions and fistulas, and small bowel and colorectal cancer. Therefore, the aim of treatment is no longer a simple clinical response or even remission, but a state of biological and tissue remission ideally associated with the absence of disease progression. Any therapeutic decision in IBD, either escalating or de-escalating the treatment, must be made by taking this into…