RT Journal Article SR Electronic T1 How achievable are STRIDE-II treatment targets in real-world practice and do they predict long-term treatment outcomes? JF Frontline Gastroenterology JO Frontline Gastroenterol FD BMJ Publishing Group Ltd SP flgastro-2022-102309 DO 10.1136/flgastro-2022-102309 A1 Susanna Meade A1 Emma Routledge A1 Esha Sharma A1 Sailish Honap A1 Sebastian Zeki A1 Shuvra Ray A1 Simon H C Anderson A1 Jeremy Sanderson A1 Joel Mawdsley A1 Peter M Irving A1 Mark A Samaan YR 2022 UL http://fg.bmj.com/content/early/2022/12/06/flgastro-2022-102309.abstract AB Objective The second iteration of the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE-II) initiative recommends use of the Simple Endoscopic Score for Crohn’s disease (SES-CD) as a treatment target for patients with CD. We aimed to assess whether the STRIDE-II endoscopic endpoints are achievable and whether the degree of mucosal healing (MH) affects long-term outcomes.Design/method We performed a retrospective observational study between 2015 and 2022. Patients with CD who had baseline and follow-up SES-CD scores after biological therapy initiation were included. The primary outcome was treatment failure, defined as the need for: (1) change of biological therapy for active disease (2) corticosteroid use (3) CD-related hospitalisation or (4) surgery. We compared rates of treatment failure with the degree of MH achieved. Patients were followed up until treatment failure or study end (August 2022).Results 50 patients were included and followed up for median 39.9 (34.6–48.6) months. Baseline characteristics: 62% male, median age 36.4 (27.8–43.9) years, disease distribution (L1: 4, L2: 11, L3: 35, perianal: 18). The proportion of patients achieving STRIDE-II end-points were: SES-CD≤2–25 (50%) and >50% reduction in SES-CD—35 (70%). Failure to achieve SES-CD≤2 (HR 11.62; 95% CI 3.33 to 40.56, p=0.003) or >50% improvement in SES-CD (HR 30.30; 95% CI 6.93 to 132.40, p<0.0001) predicted treatment failure.Conclusion Use of SES-CD is feasible in real-world clinical practice. Achieving an SES-CD≤2 or a greater than 50% reduction, as set out by STRIDE-II, is associated with reduced rates of overall treatment failure including CD-related surgery.Data are available upon reasonable request. Data will be shared upon reasonable request to the authors.