Universität zu Köln

Cekin, Sila ORCID: 0009-0005-9243-2007, Huenseler, Christoph ORCID: 0000-0002-3086-8201, Cantez, Serdar, Broekaert, Ilse ORCID: 0000-0002-7802-3064 and de Laffolie, Jan (2026). Therapy de‐escalation in paediatric patients with inflammatory bowel disease in remission: Data analysis from the CEDATA registry. Journal of Pediatric Gastroenterology and Nutrition, 82 (3). pp. 690-698. Wiley. ISSN 0277-2116

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Abstract

Objectives: There are no standardized criteria about stepping down from combination therapy (immunomodulator and tumor necrosis factor (TNF)‐ alpha‐inhibitors) in children with inflammatory bowel disease (IBD) to reduce risk for side effects. Our aim was to describe how de‐escalation has been performed in a large paediatric cohort and to find prognostic factors for therapy de‐escalation without the need for therapy adjustments post‐ de‐escalation. Methods: Real‐world data from CEDATA‐GPGE, a German‐Austrian registry for paediatric IBD patients, from 2004 to 2023, were analyzed. Patients not requiring therapy adjustments post‐de‐escalation and patients requiring ther- apy adjustments after de‐escalation were compared, and prognostic factors were identified. Results: Two hundred and thirty out of 6248 registered patients received combination therapy for at least 6 months. In 64 patients therapy adjust- ment was not required after de‐escalation. Crohn's disease (CD) patients, younger patients, and patients with positive modified predictors of poor outcome were significantly more often on combination therapy. Regarding de‐escalation, CD patients were more often successfully de‐escalated than ulcerative colitis (UC) and IBD‐unclassified patients. UC patients with a less severe disease manifestation (Paris classification E1 or E2) were de‐ escalated more successfully than those with more extensive disease (E3 or E4). De‐escalation to monotherapy with a biologic led to a more successful de‐escalation than de‐escalation to immunomodulator monotherapy or stopping both biologic and immunomodulator. Conclusions: De‐escalation is more likely successful in patients with CD, and de‐escalating combination therapy to monotherapy with a TNF‐alpha‐inhibitor is more advantageous. J Pediatr Gastroenterol Nutr. 2026;82:690–698.690 | wileyonlinelibrary.com/journal/jpn3 This is an open access article under the terms of the Creative Commons Attribution License, which permit

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Cekin, Sila UNSPECIFIED https://orcid.org/0009-0005-9243-2007 UNSPECIFIED Huenseler, Christoph UNSPECIFIED https://orcid.org/0000-0002-3086-8201 UNSPECIFIED Cantez, Serdar UNSPECIFIED UNSPECIFIED UNSPECIFIED Broekaert, Ilse UNSPECIFIED https://orcid.org/0000-0002-7802-3064 UNSPECIFIED de Laffolie, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-809384
Identification Number:	10.1002/jpn3.70297
Journal or Publication Title:	Journal of Pediatric Gastroenterology and Nutrition
Volume:	82
Number:	3
Page Range:	pp. 690-698
Number of Pages:	9
Date:	12 March 2026
Publisher:	Wiley
ISSN:	0277-2116
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Kinder- und Jugendmedizin > Klinik und Poliklinik für Kinder- und Jugendmedizin
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80938