Affordable Access

deepdyve-link
Publisher Website

Disease monitoring strategies in inflammatory bowel diseases: What do we mean by "tight control"?

Authors
  • Gonczi, Lorant1
  • Bessissow, Talat2
  • Lakatos, Peter Laszlo3
  • 1 First Department of Medicine, Semmelweis University, Budapest H-1083, Hungary. , (Hungary)
  • 2 Division of Gastroenterology, McGill University Health Centre, Montreal H3G 1A4, Quebec, Canada. , (Canada)
  • 3 First Department of Medicine, Semmelweis University, Budapest H-1083, Hungary. [email protected] , (Hungary)
Type
Published Article
Journal
World journal of gastroenterology
Publication Date
Nov 07, 2019
Volume
25
Issue
41
Pages
6172–6189
Identifiers
DOI: 10.3748/wjg.v25.i41.6172
PMID: 31749591
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In recent years, there has been a critical change in treatment paradigms in inflammatory bowel diseases (IBD) triggered by the arrival of new effective treatments aiming to prevent disease progression, bowel damage and disability. The insufficiency of symptomatic disease control and the well-known discordance between symptoms and objective measures of disease activity lead to the need of reviewing conventional treatment algorithms and developing new concepts of optimal therapeutic strategy. The treat-to-target strategies, defined by the selecting therapeutic targets in inflammatory bowel disease consensus recommendation, move away from only symptomatic disease control and support targeting composite therapeutic endpoints (clinical and endoscopical remission) and timely assessment. Emerging data suggest that early therapy using a treat-to-target approach and an algorithmic therapy escalation using regular disease monitoring by clinical and biochemical markers (fecal calprotectin and C-reactive protein) leads to improved outcomes. This review aims to present the emerging strategies and supporting evidence in the current therapeutic paradigm of IBD including the concepts of "early intervention", "treat-to-target" and "tight control" strategies. We also discuss the real-word experience and applicability of these new strategies and give an overview on the future perspectives and areas in need of further research and potential improvement regarding treatment targets and ("tight") disease monitoring strategies. ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.

Report this publication

Statistics

Seen <100 times