Long-term use of the anti-TNF agent infliximab might lead to an increased risk of malignancy or infection, according to Japanese researchers, but about one in four patients with ulcerative colitis (UC) will relapse if they quit using the biologic.

As the number of patients receiving maintenance treatment with infliximab is increasing, “questions have arisen regarding whether infliximab could be discontinued in some patients,” the study team notes in the The Lancet Gastroenterology and Hepatology.

In the open-label, randomised HAYABUSA study, funded in part by the biologic’s distributor, researchers compared the outcomes of 92 patients with UC on maintenance infliximab therapy (their first biologic) and in remission.

Half the patients continued on infliximab and half discontinued the therapy.