Personalizing therapy for inflammatory bowel diseases

Abstract

Inflammatory bowel diseases (IBDs; e.g., Crohn’s disease [CD] and ulcerative colitis [UC]) are chronic immunologically mediated diseases characterized by frequent relapses, often requiring hospitalization and surgery. There is substantial heterogeneity in the progressive natural history of disease with cumulative accrual of bowel damage and impairment of functioning. Recent advances in therapeutics have significantly improved our ability to achieve disease remission; yet therapies remain expensive and are associated with significant side effects precluding widespread use in all patients with IBD. Consequently, algorithms for the management of patients with IBD require a personalized approach incorporating an individual’s projected likely natural history, the probability of response to a specific therapeutic agent and an informed approach to management of loss of response to current therapies.

Keywords::

• biologics
• Crohn’s disease
• genetics
• serology
• ulcerative colitis

Financial & competing interests disclosure

AN Ananthakrishnan is supported by funding from the US National Institutes of Health (K23 DK097142). The author has served on the scientific advisory boards for Prometheus, Inc. and Janssen, Inc. The authors have no other 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.

No writing assistance was utilized in the production of this manuscript.

Notes

CD: Crohn’s disease; HSTCL: Hepatosplenic T-cell lymphoma; JC: John Cunningham; PML: Progressive multifocal leukoencephalopathy; UC: Ulcerative colitis; TPMT: Thiopurine methyl transferase.