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VIDEO: Monotherapy for maintenance applicable in certain IBD patients in deep remission
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HONOLULU — After a case-based symposium, Uma Mahadevan, MD, professor of medicine at the University of California San Francisco Center for Colitis and Crohn’s Disease, discusses her presentation on escalation and de-escalation of therapy in inflammatory bowel disease.
“My case was a patient who had severe ulcerative colitis requiring infliximab and azathioprine combination therapy,” Mahadevan said. “Six months later she was in deep remission with endoscopic evidence of healing and normal laboratory parameters, and her question was whether she should continue her infliximab and azathioprine. The patient then came back 2 years later, now married and interested in conception, and asking the same question.”
“At 6 months, in a patient who was hospitalized for severe ulcerative colitis, I would continue her combination therapy, but at 2 years when she’s considering conception and remains in deep remission, I would consider reducing her dose of azathioprine or stopping it altogether,” she said. “While you’d want combination therapy for induction, in the long-term, monotherapy as maintenance therapy can be considered in the patient in deep remission in the appropriate situation.”
Disclosures: Mahadevan reports she is a consultant for AbbVie, Janssen, Prometheus, Takeda and UCB, and has received grant/research support from Prometheus, Takeda and UCB.