{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T18:07:13Z","timestamp":1789236433902,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T00:00:00Z","timestamp":1697068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Strategies to reduce relapse using immunomodulators (IMs) after discontinuing anti\u2010tumor necrosis factor\u2010alpha (TNF\u2010\u03b1) antibody treatment are controversial in patients with ulcerative colitis (UC). In this study, we assessed the association between IMs after discontinuing anti\u2010TNF\u2010\u03b1 antibody treatment and relapse in patients with UC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective, multicenter cohort study included 257 patients with UC in clinical remission. These patients discontinued anti\u2010TNF\u2010\u03b1 antibody treatment between June 2010 and March 2019 and were followed up until March 2020. We evaluated the differences in relapse rates between patients with IMs (IM group) and those without IMs (non\u2010IM group) after discontinuing the treatment. Relapse was defined as further undergoing an induction treatment or colectomy. Cox proportional hazards models adjusted for confounders were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for relapse. Exploratory analyses were performed to identify other factors that could predict relapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the median follow\u2010up period of 22\u00a0months (interquartile range: 10\u201341), 114 relapses occurred: 42\/100 (42.0%) in the IM group and 72\/157 (45.9%) in the non\u2010IM group. In the multivariable analysis, IMs were not associated with relapse (HR, 0.95 [95% CI, 0.64\u20131.41]). In the exploratory analyses, discontinuation due to side effects (HR, 1.83 [95% CI, 1.18\u20132.82]) and younger age (HR, 0.99 [95% CI, 0.98\u20131.00]) predicted relapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Immunomodulators were not associated with relapse after discontinuing anti\u2010TNF\u2010\u03b1 antibody treatment in patients with UC. Careful patient follow\u2010up is needed when discontinuing due to side effects or when the patient is of a younger age at the time of discontinuation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16376","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T09:58:10Z","timestamp":1697104690000},"page":"66-73","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Immunomodulators after the discontinuation of anti\u2010tumor necrosis factor\u2010alpha antibody treatment and relapse in ulcerative colitis: A multicenter cohort study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9766-3553","authenticated-orcid":false,"given":"Kunio","family":"Asonuma","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Showa University Fujigaoka Hospital  Yokohama 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