Abstract:
:Strategies for management of inflammatory bowel diseases are shifting from simple control of symptoms toward full control of these diseases (clinical and endoscopic remission), with the final aim of blocking their progression and preventing bowel damage and disability. New goals have been proposed for treatment, such as treat to target and tight control based on therapeutic monitoring and early intervention. For patients who achieve clinical remission, there is often interest in discontinuation of therapy due to safety or economic concerns. We review the evidence supporting these emerging paradigms, the reasons that early effective treatment can alter progression of inflammatory bowel diseases, the importance of examining objective signs of inflammation, and the safety of reducing treatment dosage. We also discuss recent findings regarding personalization of care, including factors that predict patient outcomes and response to therapies, as well as preventative strategies.
journal_name
Gastroenterologyjournal_title
Gastroenterologyauthors
Colombel JF,Narula N,Peyrin-Biroulet Ldoi
10.1053/j.gastro.2016.09.046subject
Has Abstractpub_date
2017-02-01 00:00:00pages
351-361.e5issue
2eissn
0016-5085issn
1528-0012pii
S0016-5085(16)35171-Xjournal_volume
152pub_type
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