Deprescribing Advanced Therapies in Inflammatory Bowel Diseas

Authors

  • Elizabeth Squirell, MD, MSc., FRCPC
  • Jason Hearn, MD, MHSc
  • Mark McMillan, MD, FRCPC, CAGF

Abstract

Key Takeaways:

•  Deprescribing advanced therapies is a viable option for carefully-selected patients living with IBD.

•  We propose a systematic approach for deprescribing advanced therapies in IBD, which comprises strategic patient selection, comprehensive risk assessment, shared decision-making, rigorous monitoring, and a pre-defined rescue strategy.

•  Further research is needed to improve patient selection tools, optimize monitoring techniques, and clarify deprescribing strategies for newer agents.

Author Biographies

Elizabeth Squirell, MD, MSc., FRCPC

Dr. Elizabeth Squirell is an Assistant Professor in the Division of Gastroenterology, Department of Medicine at Queen’s University. She received her Medical Doctorate from the University of Calgary before completing her Internal Medicine Residency and a Master’s Degree in Clinical Epidemiology at Memorial University of Newfoundland. Dr. Squirell then completed her Gastroenterology Residency at Queen’s University, followed by an advanced fellowship in Inflammatory Bowel Disease at the University of British Columbia. Her clinical practice focuses on Inflammatory Bowel Disease, particularly the intersection between IBD and women’s health, while maintaining an interest in General Gastroenterology. Her research interests involve population-level epidemiology, focusing on preventative health care and pregnancy outcomes among those living with IBD.

Jason Hearn, MD, MHSc

Dr. Jason Hearn is a PGY-4 Gastroenterology resident at Queen’s University. He completed his Internal Medicine residency at Dalhousie University, after receiving his Medical Degree from Memorial University of Newfoundland. Prior to his medical training, he obtained his Master of Health Science in Clinical Engineering at University of Toronto. He aspires to practice as a community gastroenterologist.

Mark McMillan, MD, FRCPC, CAGF

Dr. Mark MacMillan graduated with a BSc from St. Francis Xavier University. He completed both medical school and his internal medicine training at Dalhousie University, which was followed by subspecialty training in gastroenterology/hepatology. He is currently the Medical Endoscopy Director at the Dr. Everett Chalmers Regional Hospital in Fredericton, NB. Dr MacMillan is an Assistant Professor for Dalhousie University and Memorial University and is active in nursing, and medical student and resident teaching. The main focus of his practice is inflammatory bowel disease and has recently been involved in several clinical trials for IBD. He is the current President of the New Brunswick Association of Gastroenterology and Chair of Canadian Association of Gastroenterology (CAG) Regional Representative Committee, and Member of CAG Clinical Affairs Committee, Advocacy Committee, and Choosing Wisely Committee. Dr MacMillan is also Chair of the Chalmers Hospital Foundation.

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Published

2025-09-23

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1.
Deprescribing Advanced Therapies in Inflammatory Bowel Diseas. Can IBD Today [Internet]. 2025 Sep. 23 [cited 2026 Mar. 31];3(2):5–12. Available from: https://canadianibdtoday.com/article/view/3-2-Squirell_et_al

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Volume 3, Issue 2, Summer 2025

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How to Cite

1.
Deprescribing Advanced Therapies in Inflammatory Bowel Diseas. Can IBD Today [Internet]. 2025 Sep. 23 [cited 2026 Mar. 31];3(2):5–12. Available from: https://canadianibdtoday.com/article/view/3-2-Squirell_et_al