Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment?
Inflammatory bowel disease (IBD) treatment was revolutionised with the arrival of biological therapy two decades ago. There are now multiple biologics and increasingly novel small molecules licensed for the treatment of IBD. Treatment guidelines highlight the need for effective control of inflammati...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-06-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/11/1/e001225.full |
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| _version_ | 1823856574011015168 |
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| author | Christian Philipp Selinger Konstantina Rosiou Marco V Lenti |
| author_facet | Christian Philipp Selinger Konstantina Rosiou Marco V Lenti |
| author_sort | Christian Philipp Selinger |
| collection | DOAJ |
| description | Inflammatory bowel disease (IBD) treatment was revolutionised with the arrival of biological therapy two decades ago. There are now multiple biologics and increasingly novel small molecules licensed for the treatment of IBD. Treatment guidelines highlight the need for effective control of inflammation and early escalation to advanced therapies to avoid long-term complications. Consequently, a large proportion of patients with IBD receive advanced therapies for a long time. Despite their beneficial risk–benefit profile, these treatments are not without risk of side effects, are costly to healthcare providers and pose a burden to the patient. It is, therefore, paramount to examine in which circumstances a temporary cessation of therapy can be attempted without undue clinical risk. Some patients may benefit from cyclical rather than continuous treatment. This review examines the risk of relapse after discontinuation of advanced therapies, how to identify patients at the lowest risk of relapse and the chance of recapturing response when flaring after discontinuation. |
| format | Article |
| id | doaj-art-4154f29452dd4f5888ad1ade982b5d1d |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-4154f29452dd4f5888ad1ade982b5d1d2025-02-12T07:25:12ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742024-06-0111110.1136/bmjgast-2023-001225Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment?Christian Philipp Selinger0Konstantina Rosiou1Marco V Lenti2Leeds Gastroenterology Institute, Leeds Teaching Hospitals, Leeds, UKDepartment of Gastroenterology, St James`s University Hospital, Leeds, UKInternal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyInflammatory bowel disease (IBD) treatment was revolutionised with the arrival of biological therapy two decades ago. There are now multiple biologics and increasingly novel small molecules licensed for the treatment of IBD. Treatment guidelines highlight the need for effective control of inflammation and early escalation to advanced therapies to avoid long-term complications. Consequently, a large proportion of patients with IBD receive advanced therapies for a long time. Despite their beneficial risk–benefit profile, these treatments are not without risk of side effects, are costly to healthcare providers and pose a burden to the patient. It is, therefore, paramount to examine in which circumstances a temporary cessation of therapy can be attempted without undue clinical risk. Some patients may benefit from cyclical rather than continuous treatment. This review examines the risk of relapse after discontinuation of advanced therapies, how to identify patients at the lowest risk of relapse and the chance of recapturing response when flaring after discontinuation.https://bmjopengastro.bmj.com/content/11/1/e001225.full |
| spellingShingle | Christian Philipp Selinger Konstantina Rosiou Marco V Lenti Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment? BMJ Open Gastroenterology |
| title | Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment? |
| title_full | Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment? |
| title_fullStr | Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment? |
| title_full_unstemmed | Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment? |
| title_short | Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment? |
| title_sort | biological therapy for inflammatory bowel disease cyclical rather than lifelong treatment |
| url | https://bmjopengastro.bmj.com/content/11/1/e001225.full |
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