Published online Nov 7, 2019. doi: 10.3748/wjg.v25.i41.6172
Peer-review started: September 8, 2019
First decision: September 19, 2019
Revised: September 26, 2019
Accepted: October 30, 2019
Article in press: October 30, 2019
Published online: November 7, 2019
Core tip: Inflammatory bowel diseases are chronic, progressive, immune-mediated disorders leading to disability and cumulative intestinal damage. There has been a major change in treatment paradigms favouring an early introduction of highly effective therapies, applying a treat-to-target approach to target composite clinical and endoscopical therapeutic endpoints and using close monitoring of objective markers of inflammation (with clinical, endoscopical and biomarker assessment) to direct therapeutic decisions until these goals are reached. Although several data support the benefit of ‘treat-to-target’ and “tight control” strategies so far, these approaches require further validation assessing long-term outcomes and more precise definition of therapeutic targets (for both endoscopic and biomarker monitoring).