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The main objectives in Crohn's disease are to avoid disease complications and preserve the patient's quality of life. Early disease control and close monitoring with specific targets to reach might be the only way to change the disease course. In two decades, we have moved from clinical response to full remission (clinical and endoscopic remission) requiring a tight monitoring of both symptoms and objective signs of inflammation. This review summarizes the concepts of tight control and treat-to-target and their potential for disease modi