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Am J Gastroenterol. 2015 Sep;110(9):1324-38. doi: 10.1038/ajg.2015.233. Epub 2015 Aug 25.

Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): Determining Therapeutic Goals for Treat-to-Target.

Author information

1
INSERM Unité 954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, University of Lorraine, Houdemont, France.
2
Division of Gastroenterology, University of California San Diego, La Jolla, California, USA.
3
Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
4
McMaster University, Hamilton, Ontario, Canada.
5
Medical University of Vienna, Vienna, Austria.
6
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
7
Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK.
8
Department of Gastroenterology, Academic Medical Centre, Amsterdam, The Netherlands.
9
Inflammatory Bowel Disease Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
10
Division of Pediatric Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
11
University of Western Ontario, London, Ontario, Canada.
12
Inflammatory Bowel Disease Center, Department of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy.
13
Department of Medicine, University of Otago, Christchurch, New Zealand.
14
Columbia University Division of Digestive and Liver Diseases, New York, New York, USA.
15
First Department of Medicine, Semmelweis University, Budapest, Hungary.
16
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
17
AP-HP, Department of Digestive Diseases, Hôpital Lariboisière Medicosurgical and University Denis Diderot, Paris, France.
18
North Zealand Hospital, Capital Region, University of Copenhagen, Copenhagen, Denmark.
19
Inflammatory Bowel Disease Group, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
20
Department of Gastroenterology, Hospital Clinic of Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain.
21
Inflammatory Bowel Disease Clinic University of Calgary, Calgary, Alberta, Canada.
22
Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
23
Division of Gastroenterology, CHU Sherbrooke, Sherbrooke, Quebec, Canada.
24
Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Chicago, Illinois, USA.
25
Dartmouth-Hitchcock Inflammatory Bowel Disease Center, Hanover, New Hampshire, USA.
26
Zane Cohen Centre for Digestive Diseases, Division of Gastroenterology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
27
Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
28
Department of General Internal Medicine, Christian-Albrechts-University, University Hospital Schleswig Holstein, Kiel, Germany.
29
Division of Gastroenterology, University of Leuven, Leuven, Belgium.
30
University of Toronto, Toronto, Ontario, Canada.
31
Service des Maladies de l'Appareil Digestif et INSERM U991, CHU Pontchaillou et Université de Rennes 1, Rennes, France.
32
Department of Hepato-Gastroenterology, Claude Huriez Hospital, Université Lille Nord de France, Lille, France.
33
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
34
Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Abstract

OBJECTIVES:

The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) program was initiated by the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD). It examined potential treatment targets for inflammatory bowel disease (IBD) to be used for a "treat-to-target" clinical management strategy using an evidence-based expert consensus process.

METHODS:

A Steering Committee of 28 IBD specialists developed recommendations based on a systematic literature review and expert opinion. Consensus was gained if ≥75% of participants scored the recommendation as 7-10 on a 10-point rating scale (where 10=agree completely).

RESULTS:

The group agreed upon 12 recommendations for ulcerative colitis (UC) and Crohn's disease (CD). The agreed target for UC was clinical/patient-reported outcome (PRO) remission (defined as resolution of rectal bleeding and diarrhea/altered bowel habit) and endoscopic remission (defined as a Mayo endoscopic subscore of 0-1). Histological remission was considered as an adjunctive goal. Clinical/PRO remission was also agreed upon as a target for CD and defined as resolution of abdominal pain and diarrhea/altered bowel habit; and endoscopic remission, defined as resolution of ulceration at ileocolonoscopy, or resolution of findings of inflammation on cross-sectional imaging in patients who cannot be adequately assessed with ileocolonoscopy. Biomarker remission (normal C-reactive protein (CRP) and calprotectin) was considered as an adjunctive target.

CONCLUSIONS:

Evidence- and consensus-based recommendations for selecting the goals for treat-to-target strategies in patients with IBD are made available. Prospective studies are needed to determine how these targets will change disease course and patients' quality of life.

PMID:
26303131
DOI:
10.1038/ajg.2015.233
[Indexed for MEDLINE]

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