Patient's profiling for therapeutic management of inflammatory bowel disease: a tailored approach

Expert Rev Gastroenterol Hepatol. 2020 Sep;14(9):765-773. doi: 10.1080/17474124.2020.1772057. Epub 2020 May 28.

Abstract

Introduction: Several biological drugs and a new small molecule are available for the treatment of Crohn's disease and ulcerative colitis. However, to date, no reliable predictors of response to treatment have yet been identified. Areas covered: We focused on studies evaluating the therapeutic management of patients with chronic inflammatory bowel diseases in order to identify any predictive factors of response to drugs and to guide therapeutic decisions based on patient and disease characteristics. Expert opinion: The heterogeneity of literature data, the main retrospective nature of the scientific evidence, and the lack of comparative head-to-head trials are the most relevant limitations for identifying factors predicting drug response. In the near future, a personalized approach to patients with chronic inflammatory diseases will be based on patient's profile to define not only the best drug to use, but also the appropriate follow-up, and the possibility of home care.

Keywords: Patient’s profile; inflammatory bowel disease; personalized medicine.

Publication types

  • Review

MeSH terms

  • Adalimumab / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Colitis, Ulcerative / drug therapy*
  • Crohn Disease / drug therapy*
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Infliximab / therapeutic use
  • Patient Selection*
  • Piperidines / therapeutic use
  • Prognosis
  • Pyrimidines / therapeutic use
  • Risk Factors
  • Ustekinumab / therapeutic use

Substances

  • Antibodies, Monoclonal, Humanized
  • Gastrointestinal Agents
  • Piperidines
  • Pyrimidines
  • tofacitinib
  • vedolizumab
  • Infliximab
  • Ustekinumab
  • Adalimumab