Crohn’s disease patients’ and gastroenterologists’ perspectives towards de-escalating inflammatory bowel disease therapy

In Crohn's disease, combination therapy with anti-tumor necrosis factor (anti-TNF) agents and azathioprine/mercaptopurine has been shown to be superior to monotherapy with one of these treatments alone.(1) This combination has its best success rate when used early in the course of treatment.(2) However, because of the significant cost of these drugs and concerns over long-term side effects,(3)(,)(4) many patients and providers often ask about stopping one or both of these medications.