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Review
. 2022 Dec;10(10):1121-1128.
doi: 10.1002/ueg2.12336. Epub 2022 Dec 12.

Treat-to-target and sequencing therapies in Crohn's disease

Nicole M Garcia  1 , Nathaniel A Cohen  1 , David T Rubin  1   2
Affiliations
Review

Treat-to-target and sequencing therapies in Crohn's disease

Nicole M Garcia et al. United European Gastroenterol J. 2022 Dec.

Abstract

Crohn's disease (CD) is a chronic immune-mediated inflammatory condition which can negatively impact a patient's quality of life. The traditional management strategy for CD has focused on symptomatic control, however, this approach fails to prevent organ damage and to change the progressive course of this disease. Thus, the field has moved towards a treat-to-target strategy that includes identifying individualized objective targets, choosing a therapy based on individual factors that include disease severity and risk, closely monitoring disease activity at predefined time points, and optimizing therapies as needed. Due to the increasing number of therapies approved for CD, this review explores the various factors which should be considered in the sequencing of treatment options together with using the treat-to-target framework to control disease activity early in its course and provide holistic patient care.

Keywords: Crohn's disease; biologic treatments; inflammatory bowel disease; sequencing; treat-to-target.

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Conflict of interest statement

NMG has no relevant disclosures. NAC has served as a consultant for Seres Pharmaceuticals and Iterative Scopes. DTR has received grant support from Takeda; and has served as a consultant for Abbvie, Altrubio, Arena Pharmaceuticals, Bristol‐Myers Squibb, Genentech/Roche, Gilead Sciences, Iterative Scopes, Janssen Pharmaceuticals, Lilly, Pfizer, Prometheus Biosciences, Takeda, and Techlab Inc.

Figures

FIGURE 1
FIGURE 1
A practical approach to incorporating treat‐to‐target decision making into clinical practice. Modified from Christensen and Rubin.
FIGURE 2
FIGURE 2
Considering therapeutic options based on co‐existing immune conditions or extraintestinal manifestations
FIGURE 3
FIGURE 3
Considerations for sequencing of medical therapies in Crohn's disease
See this image and copyright information in PMC

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