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Exit strategies in IBD: When should we stop drugs, take a drug holiday, or continue unchanged
On drug exit strategies, Edouard Louis noted that immunosuppressant and anti-TNF withdrawal is associated with an increased risk of disease relapse in both UC and CD. However, subgroups of patients in CD who are in deep remission, have normalised biomarkers and mucosal healing, have shown lower risk of relapse. Treatment withdrawal and cycles should take into account individual by cost-effectiveness, the benefit-risk profile considering patient history, risks of side effects, mucosal healing and signs of persisting inflammation.