title: Review article: moving towards common therapeutic goals in Crohn's disease and rheumatoid arthritis.
abstract: Crohn's disease (CD) and rheumatoid arthritis are chronic, progressive and disabling conditions that frequently lead to structural tissue damage. Based on strategies originally developed for rheumatoid arthritis, the treatment goal for CD has recently moved from exclusively controlling symptoms to both clinical remission and complete mucosal healing (deep remission), with the final aim of preventing bowel damage and disability.
  
  
  
  To review the similarities and differences in treatment goals between CD and rheumatoid arthritis.
  
  
  
  This review examined manuscripts from 1982 to 2016 that discussed and/or proposed therapeutic goals with their supportive evidence in CD and rheumatoid arthritis.
  
  
  
  Proposed therapeutic strategies to improve outcomes in both rheumatoid arthritis and CD include: (i) evaluation of musculoskeletal or organ damage and disability, (ii) tight control, (iii) treat-to-target, (iv) early intervention and (v) disease modification. In contrast to rheumatoid arthritis, there is a paucity of disease-modification trials in CD.
  
  
  
  Novel therapeutic strategies in CD based on tight control of objective signs of inflammation are expected to change disease course and patients' lives by halting progression or, ideally, preventing the occurrence of bowel damage. Most of these strategies require validation in prospective studies, whereas several disease-modification trials have addressed these issues in rheumatoid arthritis over the last decade. The recent approval of new drugs in CD such as vedolizumab and ustekinumab should facilitate initiation of disease-modification trials in CD in the near future.
authors.affiliation: Division of Gastroenterology, Ulster Hospital, Belfast, UK.
authors.forename: P B
authors.identifier: 0000-0002-2408-7951
authors.initials: PB
authors.lastname: Allen
authors.affiliation: Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina.
authors.forename: P
authors.initials: P
authors.lastname: Olivera
authors.affiliation: Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors.forename: P
authors.initials: P
authors.lastname: Emery
authors.affiliation: UMR 7365 IMoPA CNRS-Université de Lorraine, Biopôle de l'Université de Lorraine, Campus Biologie-Santé, Vandœuvre-lès-Nancy Cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Moulin
authors.affiliation: UMR 7365 IMoPA CNRS-Université de Lorraine, Biopôle de l'Université de Lorraine, Campus Biologie-Santé, Vandœuvre-lès-Nancy Cedex, France.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Jouzeau
authors.affiliation: UMR 7365 IMoPA CNRS-Université de Lorraine, Biopôle de l'Université de Lorraine, Campus Biologie-Santé, Vandœuvre-lès-Nancy Cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Netter
authors.affiliation: Department of Gastroenterology, IBD Center, Istituto Clinico Humanitas, Humanitas University, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Danese
authors.affiliation: Western University, London, ON, Canada.
authors.forename: B
authors.identifier: 0000-0002-6914-3822
authors.initials: B
authors.lastname: Feagan
authors.affiliation: Division of Gastroenterology, University of California San Diego, La Jolla, CA, USA.
authors.forename: W J
authors.initials: WJ
authors.lastname: Sandborn
authors.affiliation: Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Lorraine University, Vandoeuvre-les-Nancy, France.
authors.forename: L
authors.initials: L
authors.lastname: Peyrin-Biroulet
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003424:Crohn Disease / Q000188:drug therapy*; D018450:Disease Progression; D006040:Goals; D006801:Humans; D010347:Patient Care Planning / Q000639:trends*; D011446:Prospective Studies; D000069549:Ustekinumab / Q000627:therapeutic use
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C543529:vedolizumab; D000069549:Ustekinumab