Treat-to-Target Gaps in Crohn’s Disease: Insights from Real-World Practice.

Challenge

Treat-to-target strategies in Crohn's disease require regular objective monitoring and timely therapy escalation when targets are not met, yet the degree to which these practices are actually implemented in real-world US CD care—and the magnitude of the gap between guideline recommendations and practice—had not been characterized.

Solution

The TARGET-IBD registry was analyzed to quantify the proportion of CD patients not achieving treat-to-target goals and to characterize how often treatment was escalated in response, identifying the gap between recommended and actual monitoring and escalation practices across academic and community sites.

Impact

Documenting the scale of treat-to-target non-adherence in real-world CD practice provides the evidence base for prescriber education programs, supports quality improvement initiatives, and reinforces the commercial rationale for therapies that enable more reliable achievement of endoscopic and histologic treatment targets.