Reply

We appreciate the letter by Arebi and colleagues regarding our review article on the de-escalation of immunomodulators and biologic therapy in inflammatory bowel disease and agree that this review is timely during the COVID-19 pandemic. We, however, disagree with their comments that our approach was “monodimensional” and only took into account the detrimental aspects of de-escalation (ie, the risk of relapse), which may “misguide” clinicians. We are indeed well aware of the benefit provided by stopping medications, such as reducing the risk of lymphomas when stopping thiopurines, even t hough there is limited evidence beyond this observation regarding improved safety with stopping other medications.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Letter to the Editor Source Type: research