Abstract Background Advanced therapies have markedly improved the management of inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), by helping patients achieve and sustain treat-to-targets. However, under Taiwan’s National Health Insurance (NHI) programme, these treatments are often required to be discontinued after a fixed duration of one year. The consequences of this time-limited policy on disease relapse remain insufficiently understood. This study aimed to assess clinical outcomes and identify predictors of relapse in patients with moderate to severe IBD following the one-year cessation of advanced therapy. Methods Adult patients with IBD who received advanced therapy and discontinued treatment after up to one year, in accordance with NHI regulations, were retrospectively enrolled from a single centre in Taiwan between 2014 and 2025. Prior to initiating advanced therapy, all patients were required to complete a 6-month course of conventional treatment. Collected clinical data included demographics, comorbidities, IBD subtype and severity, the type of advanced therapy, and details and timing of relapse. Treat-to-target outcomes were documented after each discontinuation of advanced therapy. Predictors of clinical relapse were analysed using univariate and multivariate Cox regression, with significance set at p 0.05. Results A total of 64 patients were included in the study (34 with CD and 30 with UC). The mean time to relapse was 11.41 months in CD (relapse rate: 66.9% per person-year) and 12.17 months in UC (relapse rate: 42.4% per person-year). Selected outcomes after one year of treatment are shown in Table 1. In CD, univariate regression analysis identified both primary and secondary non-response as significant predictors of earlier relapse, whereas achieving an endoscopic response and mucosal healing was associated with a lower relapse risk. Multivariate analysis further confirmed that primary (HR 31.85, 95% CI 1.03–984.30; P = 0.048) and secondary (HR 13.00 95% CI 1.12–150.78; P = 0.04) non-response were independently associated with earlier relapse. In UC, univariate analysis showed that secondary non-response increased the risk of relapse, while achieving steroid-free remission was linked to a reduced relapse risk. Multivariate analysis confirmed secondary non-response (HR 39.19, 95% CI 4.19–366.91; P = 0.001) as an independent predictor of earlier relapse. Conclusion Mandatory discontinuation of advanced therapy after one year was associated with high relapse rates in both CD and UC. Patients who demonstrated primary or secondary non-response to advanced therapies were at substantially greater risk of clinical relapse, indicating that extended maintenance therapy may be warranted for this subgroup. Conflict of interest: Dr. Lo, Chi-Chu: No conflict of interest Chen, Kuan Chih: No conflict of interest Tsai, Chien-Chen: No conflict of interest Chung, Chen-Shuan: No conflict of interest
Lo et al. (Thu,) studied this question.