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There are many promising alternative therapeutic drugs for IBD targeting pathways.Selecting a target, disease monitoring, and treatment escalation are key components of the ‘treat-to-target’ strategy.Therapeutic drug monitoring plays a role in personalized treatment strategies for IBD.Biosimilars should be a less costly alternative to originator biologics.For the ultimate aim of preventing intestinal disability in inflammatory bowel disease (IBD), the treatment goal has moved from symptom control towards inflammation control (i.e., ‘deep remission’). Furthermore, the concept of ‘treat-to-target’ has been adopted to assist in treatment escalation and better control. Although deep remission is possible with current biologics, there are still unmet needs in IBD management. Biosimilars of several biologics will be an increasingly common option in the near future. In this review, we review the current status of novel drugs for IBD, focusing on recent phase 2 and 3 randomized controlled trials, and address the issues of biosimilars. Recent studies of the ‘treat-to-target’ strategy and therapeutic drug monitoring are summarized.