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Therapeutic Targets in Inflammatory Bowel Disease: Are We Getting the Point Across?

In their excellent study D’Haens et al1 tested the hypothesis that in patients with active Crohn’s disease targeting infliximab prespecified trough levels (TL) produces higher rates of clinical and endoscopic remission compared with adapting infliximab doses based on clinical symptoms. The primary and the main secondary endpoints—sustained corticosteroid-free clinical remission and a number of important clinical outcomes—were reached by the same proportions of patients in the 2 groups. These results might seem to be surprising because therapeutic drug monitoring (TDM) is widely used in gastroenterology and considered by many a superior tool for inflammatory bowel disease (IBD) management.

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