SynthesisJournal of Crohn's & colitis2020
Relapse From Deep Remission After Therapeutic De-escalation in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis.
Synthesis in Journal of Crohn's & colitis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Systematic review and meta-analysis: real-world data rates of deep remission with anti-TNFα in inflammatory bowel disease.BMC gastroenterology · 2021Pooled it
- Toxicity evaluation of ultra-diluted methotrexate (12c and 30c): an acute and subacute oral toxicity study in animals.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Pneumococcal Endopeptidase O Attenuates Colitis by Inhibiting the Macrophage-CCL2 Axis and Reshaping Gut Microbiota.Journal of inflammation research · 2026Article
- Leveraging patient-reported outcomes and serum markers to predict active ulcerative colitis: a multicenter cohort.Frontiers in medicine · 2026Article
- The role of neutrophils in the pathophysiology of inflammatory bowel diseases.Periodontology 2000 · 2025Review
- Is Deep Remission the Right Time to De-Escalate Biologic Therapy in IBD? A Single-Center Retrospective Study.Biomedicines · 2025Article
- Lipidated IL-22 Alone or Combined with Immunomodulatory Agents Improves Disease Endpoints and Promotes Mucosal Healing in a Mouse Model of Chronic Dextran Sodium Sulfate-Induced Colitis.Digestive diseases and sciences · 2025Article
- Marked mucosal lipid shifts in treatment refractory inflammatory bowel disease: a lipidomic study.BMC gastroenterology · 2025Article
- Biologics in the management of pediatric inflammatory bowel disease: When and what to choose.World journal of clinical pediatrics · 2025Review
- The evolving understanding of histology as an endpoint in ulcerative colitis.Intestinal research · 2024Review
- Current Treatments, Emerging Therapeutics, and Natural Remedies for Inflammatory Bowel Disease.Molecules (Basel, Switzerland) · 2024Review
- Invited commentary to immunotherapy withdrawal by step-down to mesalamine in pediatrics patients with ulcerative colitis.JPGN reports · 2024Article
- Immunotherapy withdrawal by step-down to mesalamine in pediatric patients with ulcerative colitis.JPGN reports · 2024Article
- Challenges in Defining a Reference Set of Differentially Expressed lncRNAs in Ulcerative Colitis by Meta-Analysis.Current issues in molecular biology · 2024Article
- Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment?BMJ open gastroenterology · 2024Review
- The oral-gut axis: a missing piece in the IBD puzzle.Inflammation and regeneration · 2023Review
- Smart capsule for monitoring inflammation profile throughout the gastrointestinal tract.Biosensors & bioelectronics: X · 2023Article
- Reversing the Inflammatory Process-25 Years of Tumor Necrosis Factor-α Inhibitors.Journal of clinical medicine · 2023Review
- Access to High-Cost Biological Agents: Perceptions of Brazilian Patients with Inflammatory Bowel Diseases.Journal of clinical medicine · 2023Article
- Treatment escalation and de-escalation decisions in Crohn's disease: Delphi consensus recommendations from Japan, 2021.Journal of gastroenterology · 2023Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsWe conducted a systematic review and meta-analysis evaluating the relapse rate after therapeutic de-escalation in inflammatory bowel disease [IBD] patients who achieved deep remission [DR].
methodsWe searched MEDLINE, EMBASE, and major gastroenterology conferences up to July 2019 for studies reporting relapse in adult patients with DR who subsequently underwent therapeutic de-escalation. Eligible studies defined DR as at least a combination of clinical remission and mucosal healing/endoscopic remission. The primary outcome was cumulative 1-year and 2-year relapse rates after therapeutic de-escalation. Secondary outcomes were relapse rates in ulcerative colitis [UC] and Crohn's disease [CD], relapse after anti-tumour necrosis factor-α [anti-TNFα] de-escalation, and the rate of disease response recapture following re-escalation.
resultsThirteen studies encompassing 837 patients were identified. The cumulative relapse rate after therapeutic de-escalation was 28.7% within 1 year [12 studies], and 38.4% within 2 years [eight studies]. Relapse rates within 1 year and 2 years were comparable between UC [five studies; 25.4% and 37.4%] and CD [seven studies; 34.1% and 39.9%]. Ten studies reported de-escalation of anti-TNFα, of which 29.8% patients relapsed within 1 year and 41.4% within 2 years. Response recapture following re-escalation [eight studies] was 75.4%.
conclusionsDespite achieving deep remission, therapeutic de-escalation in this patient population is associated with significant relapse risk within 1 year and 2 years. This risk is more pronounced in patients requiring anti-TNFα for management, likely because of more severe disease. Similar rates of relapse were reported among UC and CD within these time periods. These findings suggest that combined clinical and endoscopic remission should not be an impetus to consider therapeutic de-escalation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.