When, How, and in whom should we Stop Biologics?

It is now clear that prolonged anti-TNF therapy is associated with favorable outcomes including sustained remission, and reduced surgeries and hospitalization without a significant increase in mortality or cancers. Nevertheless, treatment discontinuation may be considered for various reasons including cost, remaining uncertainties about long-term safety or in specific situations, such as pregnancy. Recent data indicate that treatment discontinuation should be considered only in patients in a prolonged and stable remission and after having demonstrated deep clinical, biological and endoscopic control of the disease.