In a cohort of children with inflammatory bowel disease on combination treatment, researchers investigated the incidence and variables related with the first clinical relapse following immunomodulator (IM) discontinuation. A total of 105 individuals in clinical remission (89 with Crohn’s disease [CD]) were included in the study (91 [86.7 percent ] were on infliximab, 53 [50.5 percent ] with methotrexate, and 52 on azathioprine). The median duration of combined treatment was 2.1 years (IQR 1.3–2.8). Only 11 individuals reported a clinical recurrence following IM cessation throughout a median follow-up period of 12.0 months (IQR 5.0–19.0).

The median baseline pediatric CD activity index in those with CD who relapsed after IM cessation was 47.5 (IQR: 35.0–55.0) vs 35.0 (IQR: 20.0–52.5; P = 0.04) in those who did not relapse. The median IFX trough level at IM cessation was 6.2 g/mL in individuals who did not relapse and 3.8 g/mL in those who did.

Reference: https://journals.lww.com/jpgn/Abstract/2020/12000/Discontinuation_of_Immunosuppressive_Medications.11.aspx