John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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New therapeutic goals in IBD: STRIDE II Volume 28, supplement 5, November 2021

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Author
CHU de Nantes, Hôtel-Dieu, Institut des Maladies de l’Appareil Digestif, Service d’hépato-gastro-entérologie et oncologie digestive, 1 place Alexis-Ricordeau, 44093 Nantes Cedex 1
* Correspondance

Therapeutic goals in patients with inflammatory bowel disease (IBD) have greatly evolved in the last decade. In 2015, the STRIDE consensus defined these therapeutic targets, shifting from exclusively controlling symptoms to achieving both clinical and endoscopic remission. Since then, the rapid advent of new therapies allowed us to consider more and more stringent therapeutic goals that have been updated in the STRIDE-II consensus published by December 2020. The STRIDE-II recommendations have confirmed clinical remission and endoscopic healing as formal therapeutic targets to reach in patients with Crohn's disease (CD) and ulcerative colitis (UC), and have included normalization of CRP and fecal calprotectin, as well as restoration of growth in children. For the first time, quality of life and avoidance of disability became formal treatment targets, impacting on treatment decisions. Transmural healing in CD and histological healing in UC are not considered formal targets yet but can be assessed as measures of remission depth. Importantly, the STRIDE-II initiative placed all these treatment targets on an escalating algorithm along the timeline of specific treatments. Clinical response has to be achieved in the short term, while clinical remission and normalization of blood and fecal biomarkers are considered as intermediate targets, and endoscopic healing and normalization of PRO1 as long-term targets.