Therapeutic targets in inflammatory bowel disease

Therapeutic goals in inflammatory bowel disease (IBD) have evolved with the introduction of biologic therapies. These medications have demonstrated that resolution of mucosal inflammation was feasible. Mucosal healing has been associated with fewer complications and better patient outcomes. Hence, symptomatic control, which was considered the primary treatment goal, is no longer sufficient. Mucosal healing is now the principal target. Several biomarkers of inflammation have been studied, including C-reactive protein and fecal calprotectin. Although they are helpful in monitoring disease activity, they are still not considered therapeutic targets at this time. Ongoing research is evaluating new biomarkers as potential future targets. Resolution of histological inflammation has also been associated with better outcomes, however, the evidence is limited and the definition of histologic healing is still not clear. Ultimately, restoring quality of life is essential. In recognition of the patient's goals in wellness, patient reported outcomes are part of the therapeutic goals. When combined with mucosal healing endpoints, patient reported outcomes serve as a composite endpoint in IBD clinical trials and now patient care.