Table 1.
Characteristics of studies included in meta-analysis.
| Study | Country | Study design | DR criteria [in addition to CR+ER] | Patients enrolled fitting minimal DR criteria | Baseline therapeutics | De-escalation strategy | Median follow-up time | Recapture data | |
|---|---|---|---|---|---|---|---|---|---|
| UC | CD | ||||||||
| Echarri 2013 | Spain | Pro | No activity on bowel MRI | - | 32 | IFX/ADA +/- AZA, MTX, 5-ASA | Anti-TNFα cessation, continue other therapeutics | 34 months | Yes |
| Rismo 2013 | Norway | Pro | No additional | - | 37 | IFX/ADA +/- AZA, MTX, 5-ASA | Anti-TNFα cessation, continue other therapeutics | Did not report | No |
| Bodini 2014 | Italy | Pro | Biomarker remission | 6 | 10 | Anti-TNFα monotherapy | Anti-TNFα cessation, then randomize to 5-ASA vs AZA | 48 weeks | No |
| Dart 2014 | UK | Retro | CRP <5 mg/dL | - | 6 | IFX/ADA +/- AZA/6MP | Anti-TNFα cessation, continue other therapeutics | Did not report | No |
| Bortlik 2015 | Czech Republic | Pro | No additional | 17 | 61 | IFX/ADA +/- AZA, MTX | Anti-TNFα cessation, continue other therapeutics | 30 months | Yes |
| Molander 2015 | Finland | Pro | FC <100 µg/g | 33* | 16 | IFX/ADA +/- AZA/6MP, MTX, 5-ASA | Anti-TNFα cessation, continue other therapeutics | 13 months | Yes |
| Hlavaty 2016 | Slovakia | Pro | No activity on abdominal imaging, CRP <5 mg/dL, FC < 50 µg/g | 3 | 8 | IFX/ADA +/- AZA, 5-ASA | Anti-TNFα cessation, continue other therapeutics | 497 days | Yes |
| Fiorino 2016 | Multiple | Retro | No additional | 111 | - | IFX +/- AZA, 5-ASA | Anti-TNFα cessation, continue other therapeutics | 24 months | Yes |
| Casanova 2017 | Spain | Retro | No additional | 161 | 258 | IFX/ADA +/- thiopurines, MTX, 5-ASA | Anti-TNFα cessation, continue other therapeutics | 29 months | Yes |
| Soufleris 2018 | Greece | Pro | CRP <5 mg/dL and/or FC <250 µg/g | - | 19 | Anti-TNFα monotherapy | Anti-TNFα cessation | 43 months | Yes |
| Buda 2019 | Italy | Retro | Biochemical remission | 24 | 33 | IFX 5 mg/kg every 8 weeks monotherapy | IFX 3 mg/kg every 8 weeks | 28.4 months [mean] | Yes |
| Iborra 2019 | Spain | Pro | Biochemical remission [normal values for CRP, haemoglobin, and FC] | 35 | 60 | AZA or 6MP monotherapy | AZA or 6MP cessation | 36.7 months | Yes |
| Hisamatsu 2019 | Japan | Pro | No additional | - | 19 | ADA + thiopurines +/- 5-ASA | Thiopurines cessation, continue other therapeutics | Did not report | No |
Pro, prospective; retro, retrospective; IFX, infliximab; ADA, adalimumab; AZA, azathioprine; MTX, methotrexate; CR, clinical remission; ER, endoscopic remission; DR, deep remission; 6MP 6-mercaptopurine; CRP, C-reactive protein; FC, faecal calprotectin; TNF, tumour necrosis factor; UC, ulcerative colitis; CD, Crohn’s disease; MRI, magnetic resonance imaging.