Treat-to-Target in Pediatric Inflammatory Bowel Disease: What Does the Evidence Say?
Treat-to-Target in Pediatric Inflammatory Bowel Disease: What Does the Evidence Say?
Paediatr Drugs. 2020 Jun 23;:
Authors: D'Arcangelo G, Aloi M
Abstract
The traditional management of inflammatory bowel disease, based on treatment intensification guided by clinical activity alone, has been revised in the last 10 years and a treat-to-target approach has been proposed and is currently under evaluation as a disease-modifying strategy. Treat-to-target focuses on objective and scheduled measures to monitor intestinal damage, with consequent therapeutic adjustments in case of failure to achieve pre-defined targets. Identification of targets has been set out by the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) committee in 2015. Mucosal healing is universally accepted as the main target both in Crohn's disease and ulcerative colitis, given its proven association with better long-term outcomes than clinical remission alone. Equally important is to ensure patients' clinical remission and improve patient-reported outcomes. Transmural healing (for Crohn's disease) and histological remission (for ulcerative colitis), listed as adjunctive targets, are likely to become primary targets in the near future. The ultimate goal of this approach is to modify the natural history of inflammatory bowel diseases by trying to block bowel damage progression, with interventions in the pre-clinical stage. In this review, we will discuss ...
Source: Paediatric Drugs - Category: Pediatrics Authors: D'Arcangelo G, Aloi M Tags: Paediatr Drugs Source Type: research