The lancet. Gastroenterology & hepatology
Cure8 research brief
Why This Matters
Updated treat-to-target recommendations affect how inflammation and symptoms are monitored and when treatments should be changed. Clear targets and timing help patients and clinicians make consistent, evidence-informed decisions about escalation, optimisation, and monitoring.
The guidance also elevates patient-centred outcomes (fatigue, disability, quality of life) alongside objective inflammatory targets, supporting shared decision-making.
Who Should Pay Attention
Clinicians treating IBD (adult and pediatric), patients with Crohn’s disease or ulcerative colitis, caregivers, and clinic managers implementing treat-to-target pathways.
Study Snapshot
Story typeResearch paper
Evidence typeResearch paper
Source depthJournal abstract
What To Know
STRIDE-III is an updated international consensus (IOIBD) that revises treat-to-target recommendations for Crohn’s disease and ulcerative colitis.
The guidance groups targets into three categories: actionable targets (clinical response/remission and objective inflammatory measures such as CRP normalisation, faecal calprotectin within target range, and endoscopic remission) that should prompt treatment change when unmet; adjunctive targets (eg, urgency, histological remission in UC, transmural remission
in CD, growth) that support optimization and closer monitoring but do not always require switching therapeutic class; and patient-centred targets (disability, fatigue, quality of life) to guide shared decision-making and assessment for other causes.
STRIDE-III also specifies timing for expected achievement of targets, proposes new faecal calprotectin thresholds, and offers adaptations for resource-limited settings. The recommendations were developed from a systematic review, surveys of IOIBD and paediatric gastroenterologists, and a modified Delphi consensus process.
These updates are intended to help clinicians apply consistent, evidence-based treat-to-target care and to clarify which measures should trigger treatment escalation versus closer monitoring.
Keep In Mind
Structured content depth is an abstract from a peer-reviewed guideline article; the summary describes the consensus framework and methods (systematic review, surveys, Delphi voting) and does not provide detailed trial-level data. Local implementation may require adapting targets and timelines to available resources and individual patient circumstances.
Source Details
Review the original publication for the complete reporting, methods, and context.
Research paper
Evidence type derived from source or registry metadata.
PublicationThe lancet. Gastroenterology & hepatology
AuthorsDan Turner, Amanda Ricciuto, Shira Yuval Bar-Asher +24 more
InstitutionThe Juliet Keidan Institute of Pediatric Gastroenterology, Hepatology and Nutrition, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Study typeJournal article, review
Indexed viaPubMed
Source typeResearch paper
PublishedOct 19, 2026, 12:00 AM
Content availableJournal abstract
Conflict statement: Declaration of interests DT has received consulting fees, research grants, royalties, or honoraria from Janssen, Pfizer, Shaare Zedek Medical Center, Hospital for Sick Children, Ferring, AbbVie, Takeda, Lilly, SorrisoPharma, Boehringer Ingelheim, Galapagos, Bristol Myers Squibb (BMS), Alfasigma, Merck, and Genentech. SKV reports consulting fees from Alimentiv and speaker fees from Takeda. VS reports consulting fees from Johnson & Johnson (J&J) and Celltrion; speaker's fees from Pfizer, Takeda, Giuliani, Tillotts, Alfasigma; and travel grants from Lilly and AbbVie. MME reports speaker fees from Celltrion, Dr Falk, J&J, and Lilly. MI has received consulting fees, research grants, or honoraria from J&J, Takeda, Lilly, Olympus, Pentax, and Helmsley Charitable Trust. FR has served as a consultant to or on an advisory board for AbbVie, Abivax, Adiso, Adnovate, Agomab, Alimentiv, Allakos, Allergan, Anaptys, Arena, AstraZeneca, Bausch & Lomb, Boehringer-Ingelheim, Cabaletta, Cage, Cellarity, Celgene/BMS, Celltrion, CDISC, Celsius, Chemomab, Cowen, 89Bio, Empress, Enveda, Equillium, Eugit, Falk, Ferring, Flow Therapeutics, Forth Therapeutics, Frequency Therapeutics, Galapagos, Galmed, Genentech, Gilead, Gossamer, Granite, GSK, Guidepoint, Helios, Helmsley, Horizon Therapeutics, Image Analysis Limited, Imidomics, Index Pharma, Janssen, JT Pharma, Koutif, Landos, Lassen, Lilly, Medbiopharma, Merck, Mestag, Metacrine, Mirador, Mirum, Mobius, Mopac, Morphic, Myka Labs, Nxera, Ono, Organovo, Origo, Palisade, Pfizer, Pharvaris, Pliant, Prometheus Biosciences, Radyus, Receptos, RedX, Roche, Rubix, Samsung, Sanofi, Sironax, SRT, Surmodics, Surrozen, Takeda, Techlab, Tentarix, Teva, Thabor, Theravance, Thetis, Tillots, Transcenta, Tr1x Bio, UCB, Ventus, Versant, Viatris, Virgo, Xencor, and Ysios. RWL has served on advisory boards for AbbVie, Aspen, BMS, Celgene, Celltrion, Chiesi, Ferring, Glutagen, Hospira, Janssen, Lilly, MSD, Novartis, Pfizer, Prometheus Biosciences, Takeda, and SPYRE; and received research grants from Joanna Tiddy University of Sydney, McCusker Charitable Foundation, Celltrion, Shire, Janssen, Takeda, Gastroenterological Society of Australia, National Health and Medical Research Council, Gutsy Group, Pfizer, Medical Research Future Fund, and MSD. WR has served as a speaker for AbbVie, Alfasigma, Celltrion, Ferring, JNJ, Galapagos Medice, Lilly, MSD, Roche, Pfizer, Sobi, and Takeda; as a consultant for AbbVie, Alfasigma, Agomab, Alvotech, Anaptys Bio, Amgen, AOP Orphan, Boehringer Ingelheim, BMS, Calyx, Celltrion, Lilly, Galapagos, Gilead, Index Pharma, JNJ, Medahead, Microbiotica, MSD, OSE-Immunotherapeutics SA, Pfizer, Redex, Sanofi, Teva, Takeda, and Xencor; as an advisory board member for AbbVie, Agomab, Amgen, Boehringer Ingelheim, BMS, Celltrion, Galapagos, Janssen, Pfizer, Sanofi, and Teva; and has received research funding from AbbVie, Janssen, Sandoz, Sanofi, Takeda, and Xencor. EVL Jr has consulted for AbbVie, Abivax, Astellas, Biocon, Celltrion, Lilly, Gilead, Iota Bioscience, Iterative Health, J&J, Kymera, Merck, Ono Pharma, RegCell, Takeda, TR1X Bio, and Xencor; received research support from AbbVie, Gilead, J&J, Merck, and TR1X Bio; served on data monitoring committees for Lilly, Genentech, Morphic, Shattuck Labs, and Spyre; and owns shares in Exact Sciences and Moderna. LP-B reports consulting for AbbVie, Abivax, Adacyte, Alfasigma, Alimentiv, Amgen, Apini, Applied Molecular Transport, Arena, Banook, BMS, Celltrion, Cytoki Pharma, Enthera, Ferring, Fresenius Kabi, Galapagos, Genentech, Gilead, GlaxoSmithKline (GSK), IAG Image Analysis, Index Pharmaceuticals, Inotrem, Iterative Health, J&J, LifeMine, Lilly, Medac, Mopac, Morphic, MSD, Nordic Pharma, Novartis, Oncodesign, Precision Medicine, ONO Pharma, OSE Immunotherapeutics, Par’ Immune, Pfizer, Prometheus, Roche, Roivant, Samsung, Sandoz, Sanofi, Sorriso, Spyre, Takeda, Teva, ThirtyFiveBio, Tillotts, Vectivbio, Vedanta, and Ventyx; and received lecture fees from AbbVie, Alfasigma, Amgen, Arena, Biogen, Celltrion, Ferring, Galapagos, Genentech, Gilead, Iterative Health, J&J, Lilly, Medac, MSD, Nordic Pharma, Pfizer, Sandoz, Takeda, and Tillotts. SD has received honoraria as a speaker, consultant, and/or advisory board member from AbbVie, Allergan, Amgen, AstraZeneca, Athos Therapeutics, Biogen, Boehringer Ingelheim, Celgene, Celltrion, Lilly, Enthera, Ferring, Gilead, Hospira, Inotrem, Janssen, J&J, MSD, Mundipharma, Mylan, Pfizer, Roche, Sandoz, Sublimity Therapeutics, Takeda, TiGenix, UCB, and Vifor. RP reports consulting and/or speaker fees from Abbott, AbbVie, Abivax, Alimentiv, Alentis Therapeutics, Amgen, AnaptysBio, Apogee Therapeutics, AstraZeneca, Biogen, Boehringer Ingelheim, BMS, Caldera, Candid Therapeutics, Celgene, Celltrion, Cosmos Pharmaceuticals, Eisai, Elan, Lilly, Enthera, Ferring, Galapagos, Inviva, Fresenius Kabi, Genentech, Gilead Sciences, GSK, JAMP Bio, Janssen, Merck, Mirador, Net Biotix, Novartis, Oppilan Pharma, Odyssey Therapeutics, Organon, Oruka Therapeutics, Palisade, Pandion Pharma, Pendopharm, Pfizer, Progenity, Prometheus Biosciences, Protagonist Therapeutics, Repertoire Immune Medicines, Roche, Sandoz, Sanofi, Satisfai Health, Shire, Sorriso, Simcare Therapeutics, Shattuck Labs, Sublimity Therapeutics, Spyre Therapeutics, Takeda Pharmaceuticals, Teva, Tillotts, Theravance, Trellus, Union Biopharma, Viatris, Ventyx, and UCB. TY declares fees for lectures and speakers bureaus from AbbVie, EA Pharma, JIMRO, Kissei Pharmaceutical, Gilead Sciences, Kyorin Pharmaceutical, Celltrion Healthcare Japan, Takeda, Mitsubishi Tanabe, Nippon Kayaku, Pfizer Japan, BMS, Mochida Pharmaceutical, and Janssen. SS has received personal fees from AbbVie, Amgen, Arena, Biogen, BMS, Celgene, Celltrion, Falk, Ferring, Fresenius Kabi, Galapagos, Gilead, IMAB, Janssen, Lilly, MSD, Mylan, Novartis, Pfizer, Protagonist, Provention Bio, Roche, Sandoz/Hexal, Shire, Takeda, and Ventyx. SS is a co-inventor of intellectual property owned by CONARIS (the company holds patents for the IL-6 trans-signalling inhibitor olamkicept, of which development is at a pre-commercial stage; no payments have been or are yet received by SS). MD has acted as a consultant and received advisory fees from Abivax, AbbVie, AstraZeneca, Boehringer Ingelheim, BMS, Celltrion, Lilly and Company, Genentech, Janssen, J&J, Merck, Novartis, Pfizer, Prometheus Laboratories, Sanofi, Spyre Therapeutics, Takeda, Target RWE, and Tentarix. CNB is supported by the Bingham Chair in Gastroenterology, and has served on advisory boards for AbbVie Canada, Amgen Canada, BMS Canada, Celltrion, Lilly Canada, Ferring Canada, Fresenius-Kabi Canada, Janssen Canada, Pendopharm Canada, Sandoz Canada, Takeda Canada, and Pfizer Canada; received educational grants from AbbVie Canada, Boston Scientific, BMS Canada, Lilly, Ferring Canada, Pfizer Canada, Takeda Canada, Janssen Canada, Organon Canada, Lilly Canada, and Amgen Canada; has acted on speaker's panels for AbbVie Canada, Fresenius-Kabi Canada, Janssen Canada, Pfizer Canada, and Takeda Canada; and received research funding from AbbVie Canada, Amgen Canada, Sandoz Canada, Takeda Canada, and Pfizer Canada. DTR has received grant support from Takeda, Pfizer, and Gastro-intestinal Research Foundation; has served as a consultant for AbbVie, Abivax, Altrubio, Athos Therapeutics, BMS, Celltrion, Clostrabio, Connect BioPharma, Lilly, Genentech (Roche), Gilead, Iterative Health, J&J, Merck, Mirador, Odyssey Therapeutics, Pfizer, Sanofi, Spyre, Takeda Pharmaceuticals, Throne, Vedanta Biosciences, and Ventyx; has received honoraria for lectures from AbbVie, J&J, Pfizer and Takeda; has received payment for expert testimony from Goldman Ismail, has participated in a data safety monitoring board (DSMB) for TRX; and holds stock options from Iterative Health. GJM reports consulting fees from AbbVie, Takeda, and Sandoz; speaker's fees from Pfizer, Takeda, AbbVie, J&J, Ferring, Sandoz, Inovis, Cube, BMS, High5MD, and Vianex; travel grants from Ferring, AbbVie, J&J, Cube, Sandoz, and Vianex; and fees for participation in DSMBs or advisory boards from Takeda, AbbVie, J&J, BMS, Sandoz, and Vianex. FM has received lecture fees from AbbVie, Abivax, Adacyte, Alfasigma, Amgen, BMS, Celltrion, Ferring, Falk, Fresenius Kabi, Galapagos, Gilead, GSK, Janssen, Lilly, Laboratorios Vitoria, MSD, OM Pharma, Pfizer, Roche, Sandoz, Sanofi, Takeda, Teva, and Tillotts. ID reports fees for consultation, advisory boards, honoraria for speaking and teaching, royalties, or grant support from AbbVie, American Gastroenterology Association, AstraZeneca, Athos, Agomab, BMS, Lilly, Falk Pharma, Ferring, Friedevents AG, Gilead, Galapagos, IBDnet, Institut des MICI, Roche, Janssen, Materia Prima, Mirador, MSD, Nestle, Pfizer, Prometheus Biosciences, Sandoz, Sangamo, Spyre Therapeutics, and Takeda; she is shareholder, co-founder, and medical director of Harp Diagnostics (a medical diagnostics company developing a rapid remote and point-of-care monitoring platform for inflammatory bowel disease and other gastrointestinal conditions, which had no involvement with any aspect of this paper). VJ has received consulting fees from AbbVie, Abivax, Alimentiv, Amgen, Anaptys Bio, Asahi Kasei, Asieris, AstraZeneca, Attovia, Blackbird Labs, BMS, Boehringer Ingelheim, BiomeBank, Cabaletta, Caldera, Calluna, Campfield, Catalytic Health, Celltrion, Ensho, Enthera, Enveda, Equillium, Exeliome Biosciences, Ferring, Fresenius Kabi, Gilead, Granite Bio, GSK, Hengrui, Janssen, Lilly, Merck, Mobius, MRM Health, Nxera, Orbimed, Organon, OSE Immunotherapeutics, Palisade Bio, Pendopharm, Pioneering Medicine, Pfizer, Pharmanest, Pipr Therapeutics, Prometheus, Protillion, Roche/Genentech, Sanofi, SCOPE, Shattuck Labs, Sinomab, Sorriso, Spyre, Synedgen, Takeda, Teva, ThirtyFiveBio, Tillotts, Throne Scientific, Tr1X, UCB, Union Therapeutics, Ventus, Ventyx, Vividion, Xencor, and Zealand Pharma; payment for lectures from AbbVie, Ferring, Janssen, Pfizer, Takeda, and Lilly; and has participated in DSMBs for AbbVie, Takeda, Janssen, BMS, Fresenius Kabi, Gilead, Roche, Lilly, Boehringer Ingelheim, BiomeBank, Caldera, Celltrion, Pfizer, and Abivax. AD reports fees for participation in clinical trials, review activities such as DSMBs, statistical analysis, and endpoint committees from Abivax, AbbVie, Falk, J&J, Pfizer, and Takeda; consultancy fees from AbbVie, Alfasigma, Amgen, J&J, Lilly, MSD, Pfizer, Pharmacosmos, Roche, Sandoz, Stada, and Takeda; payment from lectures including service on speakers bureaus from AbbVie, Alfasigma, CED Service GmbH, Celltrion, Falk, Fresenius Kabi, Ferring, Gilead, Hexal, High5MD, J&J, Materia Prima, MedToday, MSD, Pfizer, Sandoz, Streamed-Up, Takeda, and Vifor Pharma; and payment for manuscript preparation from AbbVie, Falk, J&J, Takeda, Thieme, and UniMed Verlag. AR, SYB-A, NB, YY, and VA declare no competing interests.
This Cure8 brief is based on source text from the linked article. Cure8 is informational only and is not a substitute for professional medical advice, diagnosis, or treatment.
Intestinal ultrasound: a non-invasive alternative to monitor and predict biologic treatment persistence in patients with inflammatory bowel disease.
A non-invasive test (intestinal ultrasound) that predicts whether patients stay on biologic therapy could reduce the need for frequent endoscopy and help guide monitoring decisions.
Physical Activity and Fitness in Pediatric Inflammatory Bowel Disease
Physical activity may be a modifiable factor that could improve fitness, inflammation, symptoms like fatigue, and quality of life in children with IBD. This trial will provide objective, randomized data relevant to...
C-Reactive Protein-to-Albumin Ratio in Pediatric Inflammatory Bowel Disease: Associations with Disease Activity and Comparison with C-Reactive Protein Alone
This paper evaluates CAR, a simple blood‑based biomarker, in children with IBD and finds it reflects disease severity and changes over time in pediatric Crohn’s disease. That matters because reliable, easy-to-measure...