Treatment targets in IBD: is it time for new strategies?

Inflammatory bowel diseases' traditional management focused primarily on symptom control, often failing to prevent long-term complications such as disease progression, disabilities, hospitalizations and surgeries. The introduction of biologics and small molecules has revolutionized IBD management, enhancing inflammation control. A pivotal advance in this field is represented by the Treat-to-Target approach, which prioritizes the achievement of specific goals like endoscopic remission and biomarker normalization, thus moving beyond symptomatic relief. The STRIDE recommendations have been pivotal in shaping treatment goals, with STRIDE-II advancing this approach by adding timelines to established targets and suggesting histologic remission for UC and transmural healing for CD as supplementary objectives. Future strategies are expected to incorporate these outcomes, aiming for more comprehensive disease control. This review evaluates whether new therapeutic targets are required to address the unmet needs in IBD management and to further improve longterm patient outcomes.