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

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
• personalized medicine
• inflammatory bowel disease

Article highlights

• Several drugs have been developed and approved for the treatment of Crohn’s disease and ulcerative colitis, but no reliable predictor of response to treatment has yet been identified.

• Multiple patient and disease characteristics appear to be related to the response to treatments.

• The heterogeneity of the studies and the lack of comparative head-to-head trials among the available drugs do not allow to draw definitive conclusions on predictors of response to treatment.

• Personalized IBD management should include not only the choice of the best drug, but also an individualized follow-up and an approach based on the patient’s profile.

Declaration of interest

G Fiorino received consultancy fees from Ferring, MSD, AbbVie, Takeda, Janssen, Amgen, Sandoz, Samsung Bioepis, Celltrion. F Furfaro received consulting fees from MSD and Abbvie and lecture fees from Janssen and Pfizer. M Allocca received consulting fees from Nikkiso Europe and lecture fees from Janssen and Pfizer. L Peyrin-Biroulet has served as a speaker, consultant and advisory board member for Merck, Abbvie, Janssen, Genentech, Mitsubishi, Ferring, Norgine, Tillots, Vifor, Hospira/Pfizer, Celltrion, Takeda, Biogaran, Boerhinger-Ingelheim, Lilly, HAC-Pharma, Index Pharmaceuticals, Amgen, Sandoz, Forward Pharma GmbH, Celgene, Biogen, Lycera, Samsung Bioepis, Theravance. S Danese has served as a speaker, consultant, and advisory board member for Schering-Plough, AbbVie, Actelion, Alphawasserman, AstraZeneca, Cellerix, Cosmo Pharmaceuticals, Ferring, Genentech, Grunenthal, Johnson and Johnson, Millenium Takeda, MSD, Nikkiso Europe GmbH, Novo Nordisk, Nycomed, Pfizer, Pharmacosmos, UCB Pharma and Vifor. The other authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.