Precision Medicine: Predicting Disease Course in Patients with Inflammatory Bowel Disease

AbstractPurpose of reviewThere is increasing demand for a personalized approach to management of patients with inflammatory bowel disease (IBD). Early prognostication and stratification of patients into distinct disease trajectories would enable treatment algorithms to be made which are less generalized and more patient-specific. We have summarized the recent medical literature and highlight the current status of precision medicine and its potential application to patients with IBD.Recent findingsClinical characteristics, aided by serologic studies, fecal and genetic markers are commonly employed to approximate an IBD patient ’s future trajectory and guide therapeutic treatment decisions. More composite models that aggregate these markers have been proposed in individual studies and made available as easy to use web-based calculators, to estimate the future potential risk of need for bowel surgery, future risk of hospi talization, and development of different complications. Unique biomarkers such as metalloproteinase 3, oncostatin M, and TREM-1 have been identified which may prove useful to assist clinicians to make a choice between different biologic medications for any given patient. In addition, recent data sug gest that the presence of the HLA-DQA1*05 allele may predict a higher risk for immunogenicity with anti-TNF agent monotherapy.SummaryWhile several biomarkers and preliminary predictive models have been proposed, additional rigorous studies in the realms of genomic...
Source: Current Treatment Options in Gastroenterology - Category: Gastroenterology Source Type: research