Abstract:
BACKGROUND:The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) initiative of the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) has proposed treatment-targets in 2015 for adult IBD patients. We aimed to update the original STRIDE statements for incorporating treatment targets in both adult and pediatric IBD. METHODS:Based on a systematic review of the literature and iterative surveys of 89 IOIBD members, recommendations were drafted and modified in two surveys and two voting rounds. Consensus was reached if ≥75% of participants scored the recommendation as 7-10 on a 10-point rating scale. RESULTS:In the systematic-review, 11,278 manuscripts were screened, of which 435 were included. The first IOIBD survey (n=39 on Crohn's Disease (CD) and n=36 on ulcerative colitis (UC)) identified the following targets as most important: clinical response and remission, endoscopic healing, and normalization of C-reactive protein/erythrocyte sedimentation rate and calprotectin. Fifteen recommendations were identified, of which 13 were endorsed (n=70). STRIDE-II confirmed STRIDE-I long-term targets of clinical remission and endoscopic healing and added absence of disability, restoration of quality of life and normal growth in children. Symptomatic relief and normalization of serum and fecal markers have been determined as short-term targets. Transmural healing in CD and histological healing in UC are not formal targets but should be assessed as measures of the remission depth. CONCLUSIONS:STRIDE-II encompasses evidence- and consensus-based recommendations for treat-to-target strategies in adults and children with IBD. This framework should be adapted to individual patients and local resources to improve outcomes.
journal_name
Gastroenterologyjournal_title
Gastroenterologyauthors
Turner D,Ricciuto A,Lewis A,D'Amico F,Dhaliwal J,Griffiths AM,Bettenworth D,Sandborn WJ,Sands BE,Reinisch W,Schölmerich J,Bemelman W,Danese S,Mary JY,Rubin D,Colombel JF,Peyrin-Biroulet L,Dotan I,Abreu MT,Dignass Adoi
10.1053/j.gastro.2020.12.031subject
Has Abstractpub_date
2020-12-21 00:00:00eissn
0016-5085issn
1528-0012pii
S0016-5085(20)35572-4pub_type
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