Review article: Translating STRIDE‐II into clinical reality – Opportunities and challenges

Dignaß, Axel; Rath, Stefan; Kleindienst, Thomas; Stallmach, Andreas

doi:10.1111/apt.17622

Cited by 16 publications

(7 citation statements)

References 59 publications

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“…Therapeutic studies demonstrated that the absence of symptoms was not capable of preventing the natural progression of IBD, thus, studies with an emphasis on clinical outcomes. Among numerous proposals, the proposal of the International Organization for IBD (IOIBD) is considered among the most relevant, which proposes target-directed therapy (Treat to Target—T2T) considering the short-term objectives (such as clinical response), medium-term (such as reduction in inflammatory markers), and long-term (such as mucosal healing) [ 16 , 22 ]. The same institution also proposes continuous care to patients with the proposal of the SPIRIT consensus, which warns about care in the different manifestations of the disease, even after controlling the inflammatory activity [ 23 ].…”

Section: Therapies and Therapeutic Goalsmentioning

confidence: 99%

Pharmacological Therapy in Inflammatory Bowel Diseases: A Narrative Review of the Past 90 Years

Imbrizi,

Magro,

Coy

2023

Pharmaceuticals

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Inflammatory Bowel Diseases had their first peak in incidence in countries in North America, Europe, and Oceania and are currently experiencing a new acceleration in incidence, especially in Latin America and Asia. Despite technological advances, 90 years after the development of the first molecule for the treatment of IBD, we still do not have drugs that promote disease remission in a generalized way. We carried out a narrative review on therapeutic advances in the treatment of IBD, the mechanisms of action, and the challenges facing the therapeutic goals in the treatment of IBD. Salicylates are still used in the treatment of Ulcerative Colitis. Corticosteroids have an indication restricted to the period of therapeutic induction due to frequent adverse events, while technologies with less systemic action have been developed. Most immunomodulators showed a late onset of action, requiring a differentiated initial strategy to control the disease. New therapeutic perspectives emerged with biological therapy, initially with anti-TNF, followed by anti-integrins and anti-interleukins. Despite the different mechanisms of action, there are similarities between the general rates of effectiveness. These similar results were also evidenced in JAK inhibitors and S1p modulators, the last therapeutic classes approved for the treatment of IBD.

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Section: Therapies and Therapeutic Goalsmentioning

confidence: 99%

Pharmacological Therapy in Inflammatory Bowel Diseases: A Narrative Review of the Past 90 Years

Imbrizi,

Magro,

Coy

2023

Pharmaceuticals

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“…The existing studies demonstrate that approximately 50% of IBD patients can achieve MH without a T2T strategy, with specific rates dependent on the intervention, definition of MH, and time of assessment [33]. There are currently no data comparing the rates of achieving MH between a T2T and symptom-based approach to IBD management.…”

Section: Evidence Of Treat-to-target Strategies Incorporating Serial ...mentioning

confidence: 99%

“…Where MH is often not achieved, decisions to escalate treatment will need to be weighed against the relative paucity of therapeutic options available, particularly for patients in symptomatic remission who are otherwise clinically well. Randomised, controlled data are needed, demonstrating the long-term effects of MH before a treatment approach ultimately geared towards MH can be incorporated into real-world clinical practice [33]. Further, clear, evidence-based recommendations are needed for cases where MH is unable to be achieved despite adequately directed therapy.…”

Section: Effect On Therapeutic Decision Makingmentioning

confidence: 99%

Benefits and Challenges of Treat-to-Target in Inflammatory Bowel Disease

West,

Tan,

Devi

et al. 2023

JCM

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There is notable disparity between symptomatology and disease activity in a significant proportion of patients with inflammatory bowel disease (IBD), and escalation of treatment based on symptoms alone can fail to significantly alter the course of disease. The STRIDE-II position statement, published in 2021 by the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) initiative of the International Organisation for the Study of IBD (IOIBD) provides the most current recommendations for a treat-to-target (T2T) approach in IBD. Despite the benefits offered by a T2T approach in IBD, there are numerous drawbacks and current limitations to its widespread implementation in real-world clinical practice. Owing to the lack of a standardised definition of MH, outcome data are heterogeneous and limit the comparability of existing data. Further, studies investigating the likelihood of achieving MH with a T2T approach are limited and largely retrospective. Evidence of the real-world feasibility of tight monitoring is currently minimal and demonstrates sub-optimal adherence among patients. Further, the few studies on the acceptability and uptake of a T2T approach in real-world practice demonstrate the need for increased acceptability on both patients’ and clinicians’ behalf. Real-world applicability is further limited by the need for repeated endoscopic assessments of MH as well as a lack of guidance on how to incorporate the various treatment targets into therapeutic decision-making. We aim to review the benefits and challenges of the T2T approach and to discuss potential solutions to further patient care.

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“…Kedia and Ahuja for their insightful comments and for highlighting additional shortcomings in the management of Crohn's disease (CD) and ulcerative colitis (UC). 1,2 Despite new therapeutic options, we still cannot achieve the desired long-term outcomes of steroid-free remission, mucosal and transmural healing, prevention of invalidity and disability, unimpaired quality of life and avoidance of long-term therapy-related adverse events in all patients with IBD. 3 They pointed out important differences in the natural disease course, monitoring and treatment strategies of CD and UC and suggested that CD may need a more aggressive approach.We agree that the current classification of IBD might be too simplistic to reflect the complexity and differences between the two diseases.…”

mentioning

confidence: 99%

“…We thank Drs. Kedia and Ahuja for their insightful comments and for highlighting additional shortcomings in the management of Crohn's disease (CD) and ulcerative colitis (UC) 1,2 . Despite new therapeutic options, we still cannot achieve the desired long‐term outcomes of steroid‐free remission, mucosal and transmural healing, prevention of invalidity and disability, unimpaired quality of life and avoidance of long‐term therapy‐related adverse events in all patients with IBD 3 .…”

mentioning

confidence: 99%

Editorial: If STRIDE‐II is the hammer, then Crohn's disease and ulcerative colitis are not the same nails—Authors' reply

Dignass,

Rath,

Kleindienst

et al. 2023

Aliment Pharmacol Ther

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Review article: Translating STRIDE‐II into clinical reality – Opportunities and challenges

Cited by 16 publications

References 59 publications

Pharmacological Therapy in Inflammatory Bowel Diseases: A Narrative Review of the Past 90 Years

Pharmacological Therapy in Inflammatory Bowel Diseases: A Narrative Review of the Past 90 Years

Benefits and Challenges of Treat-to-Target in Inflammatory Bowel Disease

Editorial: If STRIDE‐II is the hammer, then Crohn's disease and ulcerative colitis are not the same nails—Authors' reply

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