Precision Medicine and Drug Optimization in Adults Inflammatory Bowel Disease Patients

Vieujean, Sophie; Louis, Edouard

doi:10.1177/17562848231173331

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Precision Medicine and Drug Optimization in Adults Inflammatory Bowel Disease Patients

Vieujean, Sophie; Louis, Edouard

2023 • In Therapeutic Advances in Gastroenterology

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https://hdl.handle.net/2268/302351

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10.1177/17562848231173331

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Keywords :

Precision medicine; Inflammatory bowel disease; Drug optimisation

Abstract :

[en] Inflammatory bowel diseases encompass two main entities including ulcerative colitis and Crohn’s disease. Although having a common global pathophysiological mechanism, inflammatory bowel disease patients are characterized by a significant interindividual heterogeneity and may differ by their disease type, disease locations, disease behaviours, disease manifestations, disease course as well as treatment needs. Indeed, although the therapeutic armamentarium for these diseases has expanded rapidly in recent years, a proportion of patients remains with a suboptimal response to medical treatment due to primary no response, secondary loss of response or intolerance to currently available drugs. Identifying, prior to treatment initiation, which patients are likely to respond to a specific drug would improve the disease management, avoid unnecessary side effects, and reduce the healthcare expenses. Precision medicine classifies individuals into sub-populations according to clinical and molecular characteristics with the objective to tailor preventative and therapeutic interventions to the characteristics of each patient. Interventions would thus be performed only on those who will benefit, sparing side effects and expense for those who will not. This review aims to summarize clinical factors, biomarkers (genetic, transcriptomic, proteomic, metabolic, radiomic or from the microbiota) and tools that could predict disease progression to guide towards a step-up or top-down strategy. Predictive factors of response or non-response to treatment will then be reviewed, follow by a discussion about the optimal dose of drug required for patients. The time at which these treatments should be administered (or rather can be stopped in case of a deep remission or in the aftermath of a surgery) will also be addressed. Inflammatory bowel diseases remain biologically complex diseases, with multifactorial etiopathology, clinical heterogeneity as well as temporal and therapeutic variabilities, which makes precision medicine especially challenging in this area. Although applied for many years in oncology, it remains an unmet medical need in inflammatory bowel disease.

Disciplines :

Gastroenterology & hepatology

Author, co-author :

Vieujean, Sophie ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive

Louis, Edouard ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gastroentérologie, hépatologie, onco. digestive

Language :

English

Title :

Precision Medicine and Drug Optimization in Adults Inflammatory Bowel Disease Patients

Publication date :

2023

Journal title :

Therapeutic Advances in Gastroenterology

ISSN :

1756-283X

eISSN :

1756-2848

Publisher :

SAGE Publications, United Kingdom

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 07 May 2023

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