Immunomodulators Can Be Withdrawn in Patients with Crohn Disease on Infliximab

Initiation of infliximab concurrent with immunomodulators is more effective at inducing and maintaining remission in Crohn disease than initiation of either agent alone. Cotherapy also prevents the development of anti-infliximab antibodies during the first year of therapy. However, clinicians may be interested in withdrawing immunomodulators because of toxicity concerns or because the patients were “immunomodulator resistant” prior to receiving infliximab, raising doubt that the immunomodulator was contributing to the therapeutic effect.

Investigators retrospectively assessed the effects of immunomodulator withdrawal in 158 patients receiving cotherapy for ≥6 months. Eighty percent received immunomodulators before infliximab was initiated. T…