Evolving Short- and Long-Term Goals of Management of Inflammatory Bowel Diseases: Getting It Right, Making It Last

Catherine Le Berre, Amanda Ricciuto, Laurent Peyrin-Biroulet, Dan Turner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Short- and long-term treatment targets in inflammatory bowel diseases (IBDs) evolved during the last decade, shifting from symptom control to endoscopic healing and patient-centered parameters. The STRIDE-II consensus placed these targets on a timeline from initiating treatment and introduced additional targets, normalization of serum and fecal biomarkers, restoration of quality of life, prevention of disability, and, in children, restoration of growth. Transmural healing in Crohn's disease and histologic healing in ulcerative colitis currently serve as adjunct measures to gauge remission depth. However, whether early treatment according to a treat-to-target paradigm affects the natural course of IBD remains unclear, leading to the need for prospective disease-modification trials. The SPIRIT consensus defined the targets for these trials to assess the long-term impact of early treatment on quality of life, disability, disease complications, risk of neoplastic lesions, and mortality. As further data emerge about the risk-benefit balance of aiming toward deeper healing, the targets in treating IBDs may continue to shift.

Original languageAmerican English
Pages (from-to)1424-1438
Number of pages15
JournalGastroenterology
Volume162
Issue number5
DOIs
StatePublished - Apr 2022

Bibliographical note

Publisher Copyright:
© 2022 AGA Institute

Keywords

  • Disease Control
  • Disease Modification
  • Natural History
  • Therapeutic Goals
  • Prospective Studies
  • Humans
  • Inflammatory Bowel Diseases/pathology
  • Quality of Life
  • Colitis, Ulcerative/diagnosis
  • Goals
  • Child
  • Remission Induction

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