Short- and long-term treatment targets in inflammatory bowel diseases (IBDs) evolved during the last decade, shifting from symptom control to endoscopic healing and patient-centered parameters. The STRIDE-II consensus placed these targets on a timeline from initiating treatment and introduced additional targets, normalization of serum and fecal biomarkers, restoration of quality of life, prevention of disability, and, in children, restoration of growth. Transmural healing in Crohn’s disease and histologic healing in ulcerative colitis currently serve as adjunct measures to gauge remission depth. However, whether early treatment according to a treat-to-target paradigm affects the natural course of IBD remains unclear, leading to the need for prospective disease-modification trials. The SPIRIT consensus defined the targets for these trials to assess the long-term impact of early treatment on quality of life, disability, disease complications, risk of neoplastic lesions, and mortality. As further data emerge about the risk-benefit balance of aiming toward deeper healing, the targets in treating IBDs may continue to shift.

中文翻译：

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不断发展的炎症性肠病管理的短期和长期目标：正确行事，使其持久


炎症性肠病 (IBD) 的短期和长期治疗目标在过去十年中不断发展，从症状控制转向内镜治疗和以患者为中心的参数。 STRIDE-II 共识将这些目标放在从开始治疗开始的时间表上，并引入了额外的目标，即血清和粪便生物标志物的正常化、生活质量的恢复、残疾的预防以及儿童生长的恢复。克罗恩病的透壁愈合和溃疡性结肠炎的组织学愈合目前作为衡量缓解深度的辅助措施。然而，根据目标治疗范式进行的早期治疗是否会影响 IBD 的自然病程仍不清楚，因此需要进行前瞻性疾病缓解试验。 SPIRIT 共识确定了这些试验的目标，以评估早期治疗对生活质量、残疾、疾病并发症、肿瘤病变风险和死亡率的长期影响。随着更多关于以更深层次治愈为目标的风险与收益平衡的数据出现，治疗炎症性肠病的目标可能会继续发生变化。