Treat to target: a proposed new paradigm for the management of Crohn's disease

Clin Gastroenterol Hepatol. 2015 Jun;13(6):1042-50.e2. doi: 10.1016/j.cgh.2013.09.006. Epub 2013 Sep 10.

Abstract

The traditional management of Crohn's disease, which is based on progressive, step-wise treatment intensification with re-evaluation of response according to symptoms, does not improve long-term outcomes of Crohn's disease and places patients at risk for bowel damage. The introduction of novel therapies and the development of new approaches to treatment in rheumatoid arthritis led to better outcomes for patients. Prominent among these is a "treat to target" strategy that is based on regular assessment of disease activity by using objective clinical and biological outcome measures and the subsequent adjustment of treatments. This approach is complementary to the concept of early intervention in high-risk patients. This review evaluates current literature on this topic and proposes a definition for the concept of treating to targets for Crohn's disease.

Keywords: Crohn's Disease; Mucosal Healing; Prevention and Control; Therapy; Treat to Target.

Publication types

  • Review

MeSH terms

  • Crohn Disease / drug therapy*
  • Drug Monitoring / methods*
  • Humans
  • Immunologic Factors / therapeutic use*
  • Intestinal Mucosa / pathology
  • Secondary Prevention / methods

Substances

  • Immunologic Factors