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The Future of IBD Is Personalized Medicine
PHILADELPHIA—Following the lead of other specialties and pursuing a personalized medicine approach for patients with inflammatory bowel disease (IBD) will allow for better treatment options, said Stephen B. Hanauer, MD, during The J Edward Berk Distinguished Lecture today at the American College of Gastroenterology Annual Meeting 2018.
“Personalized medicine has become a catch word throughout the medical field…We have to follow other specialties, like oncology, where diagnosis is no longer clinical but rather based on molecular genetics,” said Dr Hanauer, professor of medicine at Northwestern University Feinberg School of Medicine, during his lecture. “Only with that kind of comprehensive approach are we only going to be able to make greater strides in treatment for our patients.”
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IBD has remained a complex disease. As of 2018, more than 200 gene mutations have been identified as associated with ulcerative colitis (UC), Crohn disease (CD), or a combination. However, a majority of the population with one of the 200 mutations do not have IBD.
Rather, 15% of patients with IBD have one of the recognized mutations.
Factors such as diet, genetics, environment, immune system, and the microbiota all affect and can modify underlying genetics. Studies have researched the impact of various factors on genetics and IBD. Still, only 20% to 40% of remissions are reported.
“We have a number of opportunities to improve the outcome to an 80% response rate,” Hanauer said.
The evidence to improve outcomes is related to diagnosis, more research, prognosis, and targeted treatments.
Diagnosis
There is a need for optimization in the diagnosis of IBD. In 2018, the field still does not know how to define UC and CD, according to Hanauer.
“We will have to fill in the gaps in order to develop a more comprehensive approach to diagnosis,” he said.
Although more than 200 genes are associated with UC and CD, they can be seen in other diseases as well. Serology data has provided insight and have already determined the influence of microbiome and how it can be affected by diet. Changes in the diet can lead to prone inflammatory environment in the intestine.
“As a result, we are left in the middle a lot, where patients are often named as indeterminate colitis,” he said. “So, we have to consider genes.”
Omics Research, Biomarkers >>
PHILADELPHIA—Following the lead of other specialties and pursuing a personalized medicine approach for patients with inflammatory bowel disease (IBD) will allow for better treatment options, said Stephen B. Hanauer, MD, during The J Edward Berk Distinguished Lecture today at the American College of Gastroenterology Annual Meeting 2018.
“Personalized medicine has become a catch word throughout the medical field…We have to follow other specialties, like oncology, where diagnosis is no longer clinical but rather based on molecular genetics,” said Dr Hanauer, professor of medicine at Northwestern University Feinberg School of Medicine, during his lecture. “Only with that kind of comprehensive approach are we only going to be able to make greater strides in treatment for our patients.”
READ MORE MEETING NEWS...
In IBD, Can Identifying Risk Factors Improve Drug Adherence?
Novel Test Helps Monitor Gluten-Free Diet Adherence in Sensitive Patients
IBD has remained a complex disease. As of 2018, more than 200 gene mutations have been identified as associated with ulcerative colitis (UC), Crohn disease (CD), or a combination. However, a majority of the population with one of the 200 mutations do not have IBD.
Rather, 15% of patients with IBD have one of the recognized mutations.
Factors such as diet, genetics, environment, immune system, and the microbiota all affect and can modify underlying genetics. Studies have researched the impact of various factors on genetics and IBD. Still, only 20% to 40% of remissions are reported.
“We have a number of opportunities to improve the outcome to an 80% response rate,” Hanauer said.
The evidence to improve outcomes is related to diagnosis, more research, prognosis, and targeted treatments.
Diagnosis
There is a need for optimization in the diagnosis of IBD. In 2018, the field still does not know how to define UC and CD, according to Hanauer.
“We will have to fill in the gaps in order to develop a more comprehensive approach to diagnosis,” he said.
Although more than 200 genes are associated with UC and CD, they can be seen in other diseases as well. Serology data has provided insight and have already determined the influence of microbiome and how it can be affected by diet. Changes in the diet can lead to prone inflammatory environment in the intestine.
“As a result, we are left in the middle a lot, where patients are often named as indeterminate colitis,” he said. “So, we have to consider genes.”
