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5 Questions About How IBD Management Has Changed Over Time
The management of inflammatory bowel disease (IBD) is changing. There is a shift toward clinicians treating patients to achieve deep remission rather than clinical remission of their disease. However, gaps in access to care continue to delay treatment and create challenges in the overall management of the disease.
Jean-Frederic Colombel, MD, codirector of the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai and professor at Icahn School of Medicine at Mount Sinai in New York, will address these changes and future challenges during his keynote address at the Advances in Inflammatory Bowel Diseases (AIBD) Regional Meeting in Chicago. Ahead of his session, Gastroenterology Consultant caught up with Dr Colombel to talk about the importance of the changes and what needs to be done to predict and prevent the disease.
Gastroenterology Consultant: How has IBD management changed over time?
Jean-Frederic Colombel: We have been able to help patients achieve clinical remission with new therapeutics and have decreased mortality rates. Now, we are moving beyond clinical remission and aiming to achieve deep remission. We want to challenge the natural history of the disease to decrease the number of surgeries and disabilities related to the disease. It is still not perfect. We are far from achieving 100% deep remission or even histological remission in patients. There are still problems in the management of IBD, which I suspect are associated with delays in care. We need to improve access to care for patients; there is a large gap in care, especially in the United States. We also have to focus on personalizing medicine to improve the results of our therapies and tackling more therapeutic targets. Right now, all of targets are immunological. I believe we need to be much more comprehensive and consider the impact of diet. The hope for the future is to be able to predict and prevent disease.
GASTRO CON: What is the role of endoscopic healing?
J-FC: In the past, we targeted mainly symptoms to treat IBD, but now we need to go beyond the treatment of symptoms. We need to achieve endoscopic healing, and if possible, go beyond this to histological healing if we want to change the natural history of the disease. If we want to reduce the surgical rates and the disabilities caused by the disease, endoscopic healing needs to be achieved.
A multidisciplinary approach >>
The management of inflammatory bowel disease (IBD) is changing. There is a shift toward clinicians treating patients to achieve deep remission rather than clinical remission of their disease. However, gaps in access to care continue to delay treatment and create challenges in the overall management of the disease.
Jean-Frederic Colombel, MD, codirector of the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai and professor at Icahn School of Medicine at Mount Sinai in New York, will address these changes and future challenges during his keynote address at the Advances in Inflammatory Bowel Diseases (AIBD) Regional Meeting in Chicago. Ahead of his session, Gastroenterology Consultant caught up with Dr Colombel to talk about the importance of the changes and what needs to be done to predict and prevent the disease.
Gastroenterology Consultant: How has IBD management changed over time?
Jean-Frederic Colombel: We have been able to help patients achieve clinical remission with new therapeutics and have decreased mortality rates. Now, we are moving beyond clinical remission and aiming to achieve deep remission. We want to challenge the natural history of the disease to decrease the number of surgeries and disabilities related to the disease. It is still not perfect. We are far from achieving 100% deep remission or even histological remission in patients. There are still problems in the management of IBD, which I suspect are associated with delays in care. We need to improve access to care for patients; there is a large gap in care, especially in the United States. We also have to focus on personalizing medicine to improve the results of our therapies and tackling more therapeutic targets. Right now, all of targets are immunological. I believe we need to be much more comprehensive and consider the impact of diet. The hope for the future is to be able to predict and prevent disease.
GASTRO CON: What is the role of endoscopic healing?
J-FC: In the past, we targeted mainly symptoms to treat IBD, but now we need to go beyond the treatment of symptoms. We need to achieve endoscopic healing, and if possible, go beyond this to histological healing if we want to change the natural history of the disease. If we want to reduce the surgical rates and the disabilities caused by the disease, endoscopic healing needs to be achieved.
A multidisciplinary approach >>
