title: Optimization of conventional therapy in patients with IBD.
abstract: The majority of patients with IBD use conventional therapy (namely, aminosalicylates, antibiotics, corticosteroids and immunomodulatory agents) for prolonged periods of time, to both induce and maintain remission. Treatment paradigms in IBD have evolved towards a rapid escalation of therapy to achieve stringent goals, including mucosal healing and a reduction in the need for hospital admission and surgery. In this context, the failure to optimize conventional therapy can lead to a potentially effective treatment being abandoned too early, which is undesirable when only a limited number of drugs are effective in the management of IBD, and could also lead to patients being unnecessarily exposed to potentially toxic and/or expensive biologic drugs. This Review provides an overview of the many ways in which conventional therapy can be optimized, and describes strategies to improve adherence to drug regimens, such as simplifying the dosing regimen, optimizing drug delivery and dose, and tailoring medication on the basis of metabolite levels.
authors.affiliation: Department of Gastroenterology, Guy's & St Thomas' Hospitals, Westminster Bridge Road, London SE1 7EH, UK.
authors.forename: Kirstin M
authors.initials: KM
authors.lastname: Taylor
authors.forename: Peter M
authors.initials: PM
authors.lastname: Irving
mesh_terms: D005762:Gastroenterology / Q000592:standards*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D017410:Practice Guidelines as Topic
chemical_list: D005765:Gastrointestinal Agents; D007155:Immunologic Factors