Personalized Treatment for Crohn’s Disease: Current Approaches and Future Directions

Abstract

Crohn’s disease is a complex, relapsing and remitting inflammatory disorder of the gastrointestinal tract with a variable disease course. While the treatment options for Crohn’s disease have dramatically increased over the past two decades, predicting individual patient response to treatment remains a challenge. As a result, patients often cycle through multiple different therapies before finding an effective treatment which can lead to disease complications, increased costs, and decreased quality of life. Recently, there has been increased emphasis on personalized medicine in Crohn’s disease to identify individual patients who require early advanced therapy to prevent complications of their disease. In this review, we summarize our current approach to management of Crohn’s disease by identifying risk factors for severe or disabling disease and tailoring individual treatments to patient-specific goals. Lastly, we outline our knowledge gaps in implementing personalized Crohn’s disease treatment and describe the future directions in precision medicine.

Keywords:

• inflammatory bowel disease
• precision medicine
• personalized medicine
• biomarkers
• biologic therapy
• patient stratification

Disclosure

JWC reports no conflicts of interest in this work. RKC has received income from consulting and participation in advisory boards for AbbVie, Adiso, BMS, Fresenius Kabi, Fzata, Janssen, Magellan Health, Pfizer, Samsung bioepis, Sandoz, Sebela, and Takeda. RKC is a member of the Executive Committee for the IBD Education Group and is Scientific Co-Director of the CorEvitas Registry.