In order to produce consensus recommendations for therapy targets for UC and CD, the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) initiative looked at prospective targets and the data supporting them. ULCERATIVE COLITIS
The programme decided on the following as the UC target:
Rectal bleeding, diarrhoea, or altered bowel habits must stop for clinical and patient-reported remission (PRO) to occur (assessed at least every 3 months until they do, then every 6 to 12 months), plus.
A Mayo endoscopic subscore of 0 or 1 indicates endoscopic remission (assessed 3 to 6 months after starting therapy in symptomatic patients and then at least every 3 months during active disease).
STRIDE considered histologic remission to be an adjunctive target, as insufficient evidence exists to recommend histologic remission as a target in clinical practice.
The agreed target for CD was the following:(7)
- Clinical and PRO, defined as resolution of abdominal pain and diarrhea or altered bowel habit (assessed at least every 3 months until resolution, then every 6 to 12 months), plus
- Endoscopic remission, defined as resolution of ulceration at ileocolonoscopy, or resolution of inflammation on cross-sectional imaging, in patients who could not be assessed adequately by ileocolonoscopy (assessed at least every 6 to 9 months during active disease).
STRIDE considered biomarker remission, that is, normalization of C-reactive protein and fecal calprotectin to be an adjunctive target, as insufficient evidence exists to recommend treatment optimization based on biomarkers alone.