Abstract Background Current therapeutic goals in Inflammatory Bowel Disease (IBD) go beyond reaching clinical remission, striving for ambitious milestones such as attaining (and sustaining) biochemical, endoscopic and histological remissions. Fecal calprotectin (FCP) is a non-invasive stool inflammatory marker which allows closer disease monitoring. Treat-to-target (T2T) strategy, based on biomarkers such as FCP and C Reactive Protein (CRP) has proven better than therapeutic based only on symptoms. This study aims to evaluate the most used therapeutic strategies and their effectiveness according to the T2T strategy in patients with IBD. Methods A retrospective cohort study that included patients with IBD treated in the IBD clinic at the National Institute of Medical Sciences and Nutrition Salvador Zubiran who had two different FCP and CRP measurements, one before the visit to the clinic for optimization and one after to evaluate response to treatment or biochemical remission. We defined optimization as the adding of a new drug or the increase in dosage. We consider response to treatment as the decreased of at least 50% of basal value of FCP and CRP as well as biochemical remission was defined as a value of FCP below 250 ug/gr and CRP below 10mg/dL. Statistical analysis was performed with SPSS program v25. A P value of 0.05 was considered statistically significant. Results We included 127 patients, 70 women and 57 men, 25 with a diagnosis of Crohńs Disease (CD) and 102 with a Ulcerative Colitis (UC). The period of follow-up was 3 months. In 80 of the 133 patients (63%) had response to treatment optimization, of which 33 of 80 (41.3%) reach a biochemical response and 47 of the 80 patients (58.7%) had biochemical remission. The optimization treatment strategies were based on increasing the oral dose of 5-ASA (47%); adding topical mesalazine (36.2%); adjusting the dose of thiopurines (16.5%); adding budesonide or systemic steroids (40.1%) or shortening the interval administration of biological therapy (77%). Conclusion The T2T strategy was effective in 63% of IBD patients, reaching biochemical response and/or remission beyond clinical remission. All optimization treatment strategies were successful without statistical significance due to small sample size. Conflict of interest: Prof. Dr. Yamamoto-Furusho, Jesús Kazuo: No conflict of interest Gutierrez-Herrera, Fausto Damian: No conflict of interest
Yamamoto-Furusho et al. (Thu,) studied this question.