Table 1.
Predictive factors for disease recurrence after therapy withdrawal
Poor disease prognostic features | CD/UC: Young age at diagnosis and male sex |
CD: Ileal, colonic or perianal disease; stricturing/penetrating disease | |
UC: Pancolitis | |
Challenging disease control before withdrawal | Many relapses requiring add-on steroids |
Anti-TNF escalation while already on | |
Need for surgery or anti-TNF post-operative prophylaxis | |
Biochemical disease activity | High CRP levels |
Elevated fecal calprotectin | |
Elevated white cells or neutrophil count | |
Low hemoglobin levels | |
Endoscopic disease activity | No mucosal healing |
Radiological CD activity | No transmural healing |
IFX trough levels | High IFX trough levels in monotherapy |
Low IFX trough levels in combination therapy with an imunomodulator |
CD: Crohn’s disease; UC: Ulcerative colitis; TNF: Tumor necrosis factor; CRP: C-reactive protein; IFX: Infliximab.