Mak JWY, Tang W, Yip TCF, et al. - After stopping anti-tumour necrosis factor (TNF) therapy, researchers assessed the rate of relapse in perianal Crohn disease (CD). From prospective inflammatory bowel disease database of institutes in Hong Kong, Shanghai, Taiwan, Malaysia, Thailand and Singapore from 1997 to June 2019, consecutive perianal CD patients treated with anti-TNF therapy with subsequent discontinuation were retrieved. Using Kaplan-Meier method, the cumulative probability of perianal CD relapse was estimated. Higher chance of perianal CD relapse was linked to younger age at diagnosis of CD. Thiopurine maintenance was not related to a reduced likelihood of relapse. The authors discovered that 56.4% of perianal CD patients developed relapse after stopping anti-TNF therapy. After stopping anti-TNF therapy, more than half of the perianal CD patients developed relapse. Most regained response after resuming anti-TNF, however, more than one-fourth of the perianal CD patients with relapse needed defunctioning surgery. In perianal CD, radiological evaluation before stopping anti-TNF is important.