title: 'Treat to Target' - Lessons Learnt.
abstract: BACKGROUND
  Therapeutic management in inflammatory bowel diseases (IBD) has significantly changed in the last decades with the advent of biological therapy resulting in new treatment targets other than clinical symptoms.
  
  
  CONCLUSIONS
  Patient stratification in the early stage of the disease is an important step to identify patients with poor prognosis, who might benefit from early aggressive treatment to avoid complications in the later disease course. Recent randomized and hypothesis driven (e.g., Randomized Evaluation of an Algorithm for Crohn's Treatment, Post-Operative Crohn's Endoscopic Recurrence) clinical trials conducted in the biological era underscore the need of objective disease monitoring including assessment of biomarkers (e.g., C-reactive protein and calprotectin), mucosal healing and, for biologically treated patients, therapeutic drug monitoring beside clinical symptom assessment in both Crohn's disease and ulcerative colitis.
  
  
  CONCLUSIONS
  Assessing the treatment efficacy objectively has become an important element of patient monitoring besides clinical symptom assessment. Further clinical studies are needed to assess whether implementation of new therapeutic algorithms based on these targets and tight monitoring in clinical practice have the potential to further improve long-term disease outcomes in IBD.
authors.affiliation: 1st Department of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Kurti
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Vegh
authors.forename: Petra Anna
authors.initials: PA
authors.lastname: Golovics
authors.forename: Peter Laszlo
authors.initials: PL
authors.lastname: Lakatos
mesh_terms: D001691:Biological Therapy / Q000009:adverse effects; D002986:Clinical Trials as Topic; D018450:Disease Progression; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome