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T2T in Mild to Moderate UC – Can We Change the Disease Trajectory

T2T in Mild to Moderate UC – Can We Change the Disease Trajectory

21 Aug 2021 12:30 12:55
(25 mins)
Ng Siew-Chien Speaker
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The management of ulcerative colitis (UC) now incorporates a "treat to target" strategy where treatment aims to achieve objective outcomes. Targets are shown to prevent end organ dysfunction, specifically bowel damage and its complications including surgery and colorectal cancer. Further targets focus on mucosal healing. Studies that prospectively investigated this approach in UC are scanty and a treat-to-target (T2T) algorithm is not routinely used in daily clinical practice. Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) program proposed shifting the therapeutic focus on UC toward altering the natural history of the disease course by regularly monitoring objective measurements of disease activity using fecal calprotectin and tailoring treatment accordingly and this has been shown to be successful with the use of escalating mesalamine doses. Different targets can be achieved through approved drugs for mild to moderate UC; histological remission is emerging as a robust target with respect to long-term outcomes. Further studies to compare a T2T strategy with the traditional care are needed particularly in patients with mild to moderate UC.

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