Positioning of old and new biologicals and small molecules in the treatment of inflammatory bowel diseases

Table 3 Recommendations for treating to target in Crohn’s disease by the International Organization for the Study of Inflammatory Bowel Diseases[19]

Crohn’s disease	Ulcerative colitis
The consensus target is a combination of:
Clinical/1PRO remission defined as resolution of abdominal pain and diarrhea or altered bowel habits which should be assessed every 3 mo until resolution then 6-12 mo thereafter. and Endoscopic remission2 defined as resolution of ulceration at ileocolonoscopy which should be assessed at 6-9 mo intervals during the active phase	Clinical/1PRO remission defined as resolution of rectal bleeding and diarrhea or altered bowel habits which should be assessed every 3 mo until resolution then 6-12 mo thereafter. and Endoscopic remission2 defined as resolution of friability and ulceration at flexible sigmoidoscopy or colonoscopy3 which should be assessed at 3 mo intervals during the active phase
Adjunctive measures of disease activity that may be useful in the management of selected patients but are not a treatment target include:
•Faecal calprotectin	•CRP •Faecal calprotectin •Histology
Measures of disease activity that are not a target:
•Histology •Cross-sectional imaging	•Cross-sectional imaging

¹Patient reported outcomes;

²When endoscopy cannot adequately evaluate inflammation, resolution of inflammation as assessed by cross-sectional imaging can be substituted;

³While Mayo subscore of 0 may be defined as the target, there is currently insufficient evidence to recommend it in all patients; only Mayo subscore of 0-1 can be systematically recommended in practice.