Treat to target in Crohn’s disease: A practical guide for clinicians

Table 2 Treatment targets defined by Selecting Therapeutic Targets in Inflammatory Bowel Disease-II for Crohn’s disease

Treatment target	Definition
STRIDE-II endorsed treatment targets in adult patients with Crohn’s disease
Clinical response	≥ 50% decrease in baseline Patient Reported Outcomes 2 (PRO2)1; (abdominal pain and stool frequency)
Clinical remission	PRO2 with abdominal pain score ≤ 1 and stool frequency score ≤ 31; or Harvey Bradshaw Index < 5
Patient reported outcomes	Clinical outcomes evaluated using PRO2; absence of disability and normalisation of health-related quality of life
Biomarker normalisation	C-reactive protein < upper limit of normal; faecal calprotectin < 250 μg/g
Endoscopic response	> 50% improvement in simple endoscopic score-Crohn’s disease score; or > 50% improvement in Crohn’s disease endoscopic index score
Endoscopic healing	Simple endoscopic score-Crohn’s disease ≤ 2; or Crohn’s disease endoscopic index score < 3; and absence of ulcers, including aphthous ulcers
Adjunctive treatment targets
Transmural healing	Adjunct to endoscopic healing to represent a deeper level of healing; assessed using intestinal ultrasound, magnetic resonance (or computed tomography) enterography; however, a consensus definition of transmural healing remains yet to be established

¹Endorsed by Selecting Therapeutic Targets in Inflammatory Bowel Disease-II recommendations.

STRIDE: Selecting Therapeutic Targets in Inflammatory Bowel Disease.