title: Treat to target: a proposed new paradigm for the management of Crohn's disease.
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.
authors.affiliation: Division of Gastroenterology, University of California San Diego, La Jolla, California; Service des Maladie de l'Appareil Digestif et INSERM U991, Centre Hospitalier Universitaire Pontchaillou et Université de Rennes 1, Rennes, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bouguen
authors.affiliation: Division of Gastroenterology, University of California San Diego, La Jolla, California.
authors.forename: Barrett G
authors.initials: BG
authors.lastname: Levesque
authors.affiliation: Robarts Clinical Trials, University of Western Ontario, London, Ontario, Canada.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Feagan
authors.affiliation: Division of Rheumatology, University of California San Diego, La Jolla, California.
authors.forename: Arthur
authors.initials: A
authors.lastname: Kavanaugh
authors.affiliation: INSERM U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Vandoeuvre-les-Nancy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
authors.affiliation: Icahn School of Medicine at Mount Sanai, New York, New York.
authors.forename: Jean-Frederic
authors.initials: JF
authors.lastname: Colombel
authors.affiliation: University of Chicago, Chicago, Illinois.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Hanauer
authors.affiliation: Division of Gastroenterology, University of California San Diego, La Jolla, California. Electronic address: wsandborn@ucsd.edu.
authors.forename: William J
authors.initials: WJ
authors.lastname: Sandborn
mesh_terms: D003424:Crohn Disease / Q000188:drug therapy*; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007413:Intestinal Mucosa / Q000473:pathology; D055502:Secondary Prevention / Q000379:methods
chemical_list: D007155:Immunologic Factors
keywords: Crohn's Disease; Mucosal Healing; Prevention and Control; Therapy; Treat to Target