scholarly journals Personalized medicine in the treatment of inflammatory bowel diseases

2018 ◽  
Vol 90 (2) ◽  
pp. 4-11
Author(s):  
A I Parfenov ◽  
O V Knyazev ◽  
A V Kagramanova ◽  
N A Fadeeva
Keyword(s):  
Personalized Medicine ◽  
Inflammatory Bowel Diseases ◽  
Clinical Laboratory ◽  
Pathological Condition ◽  
Individualized Medicine ◽  
Individual Characteristics ◽  
Phenotypic Traits ◽  
Biological Drugs ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Personalized medicine (personalized medicine, individualized medicine) represents the totality of methods of prevention of a pathological condition, diagnosis and treatment in the event of its occurrence, based on individual patient characteristics. Such individual characteristics include genetic, epigenetic, and transcript, proteome, metabolomic and metagenomic markers, as well as a set of variable phenotypic traits - both of the patient's body and its separate tissues or cells. For example, treatment of inflammatory bowel diseases (IBD) can most clearly show the importance of applying personalized approaches. Currently in the treatment of patients with IBD paid great attention to genetic studies, monitoring of the concentration of the biological drugs and the level of antibodies to them, the role of microbiota as a predictor of effectiveness of therapy of IBD. Used clinical, laboratory, instrumental methods, as well as new biomarkers to assess the forecasting efficiency of conservative therapy in IBD patient. In the future treatment of patients with IBD will include a number of personalized data in order to better predict outcomes of the disease in each patient and more accurately select the appropriate treatment regimen.

scholarly journals History of Inflammatory Bowel Diseases

2019 ◽  
Vol 8 (11) ◽  
pp. 1970 ◽  
Author(s):  
Giovanni Clemente Actis ◽  
Rinaldo Pellicano ◽  
Sharmila Fagoonee ◽  
Davide Giuseppe Ribaldone
Keyword(s):  
20Th Century ◽  
Inflammatory Bowel Diseases ◽  
Intestinal Tuberculosis ◽  
Unknown Etiology ◽  
Biological Drugs ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Novel Strategy ◽  
Definition Of ◽  
Therapeutic Research

Inflammatory bowel diseases (IBD) are characterized by chronic inflammation of the intestinal mucosa and unknown etiology. In this review, we identified three main eras in the IBD history. Between the 19th and the 20th century, the primary task had been the definition of the diagnostic criteria in order to differentiate the new entity from intestinal tuberculosis. In the 20th century, an intense and prolific therapeutic research prevailed, culminating in the introduction of biological drugs in the clinical setting. Since the beginning of the 21st century, traditional definition criteria have been challenged by holistic criteria in an effort to seek a still unattained cure. Centuries of worldwide efforts on IBD etiology and therapy search have culminated in this novel strategy.

scholarly journals Big future for small molecule

2019 ◽  
pp. 89-91
Author(s):  
Article Editorial
Keyword(s):  
Ulcerative Colitis ◽  
Personalized Medicine ◽  
Inflammatory Bowel Diseases ◽  
Patient Characteristics ◽  
Russian Society ◽  
Medical Sciences ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Individual ◽  
Therapeutic Possibilities

The major concern for the practitioner is to determine the correct approach to the treatment. The personalized medicine allows the modern practitioner to leverage the individual patient characteristics, preventing the development of complications and disability. What therapeutic possibilities do modern gastroenterologists have for the treatment of ulcerative colitis? We asked this question to the Chairman of the Russian Society for the Study of Inflammatory Bowel Diseases, Head of the Department of Gastroenterology of Vladimirsky Moscow Regional Clinical Research Institute, Doctor of Medical Sciences, Professor Elena Alexandrovna Belousova.

scholarly journals Metallothioneins in Inflammatory Bowel Diseases: Importance in Pathogenesis and Potential Therapy Target

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Anna Socha-Banasiak ◽  
Patrycja Sputa-Grzegrzółka ◽  
Jędrzej Grzegrzółka ◽  
Krzysztof Pacześ ◽  
Piotr Dzięgiel ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Inflammatory Bowel Diseases ◽  
Low Molecular Weight ◽  
Biological Drugs ◽  
Development Of Resistance ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Therapy Target ◽  
Low Molecular Weight Proteins

Immunological disorders, increased oxidative stress, and damage to the epithelial barrier play an important role in the pathogenesis of inflammatory bowel diseases (IBDs). In the treatment of patients with Crohn’s disease (CD) and ulcerative colitis (UC), it is increasingly common to use biological drugs that selectively affect individual components of the inflammatory cascade. However, administering the medicines currently available does not always result in obtaining and maintaining remission, and it may also lead to the development of resistance to a given agent over time. Metallothioneins (MTs) belong to the group of low molecular weight proteins, which, among others, regulate the inflammation and homeostasis of heavy metals as well as participating in the regulation of the intensity of oxidative stress. The results of the studies conducted so far do not clearly indicate the role of MTs in the process of inflammation in patients with IBD. However, there are reports that suggest the possibility of using MTs as a potential target in the treatment of this group of patients.

scholarly journals P338 effectiveness and safety of biological therapies in elderly inflammatory bowel diseases patients results from a multi center study of Geteccu

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S363-S364
Author(s):  
C J Suarez Ferrer ◽  
F Mesonero ◽  
B Caballol ◽  
R Saiz Chumillas ◽  
I Bastón-Rey ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Inflammatory Bowel Diseases ◽  
Clinical Remission ◽  
Biological Treatment ◽  
Moderate Activity ◽  
Biological Drugs ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Multi Center Study

Abstract Background Biological drugs are being increasingly used for the treatment of inflammatory bowel diseases (IBD) in elderly patients. Despite the particular characteristics of this population subgroup, the efficacy and safety of these treatments in real clinical practice is poorly evaluated. Methods Retrospective and multicenter study of GETECCU, carried out in 28 Spanish hospitals. Patients with IBD who started biological treatment (Infliximab, Adalimumab, Golimumab, Ustekinumab or Vedolizumab) aged 65 years or older were included. Efficacy (clinical- at the criteria of the responsible physician-, biochemical and endoscopic) was assessed at 12-14 weeks and at 52 weeks of treatment. Adverse effects such as tumors or serious infections were also recorded. Results A total of 570 patients were included, baseline characteristics are shown in Table 1. Biologics used were: Infliximab (214, 37.5%), Adalimumab (167, 29.3%), Golimumab (16, 2.8%), Ustekinumab (73, 12.8%) and Vedolizumab (100, 17.5%). After 12-14 weeks of treatment, in 38.7% (220) of the cases clinical remission had been achieved and in 47.7% (270) there was clinical response without remission. However, 80 patients (13.9%) had no response, resulting in treatment discontinuation due to primary failure. At week 52, only 379 patients (66.5%) continued on biological treatment: 216 (57%) were in clinical remission (216, 57.0%) while 129 (34%) had response without remission and 34 (9%)had no response. In addition, 119 patients (21%) had an endoscopic study performed: 47 (39,5%) presented with endoscopic remission, 38 (31,9%) with mild activity, 28 (23,5%) with moderate activity and 6, (5.1%) with severe activity. At the end of the follow-up, only 60% of the patients continued on biological treatment, being the reason for withdraw lack of efficacy or due to the report of adverse side effects. Regarding treatment safety in this population, 12.1% (68 patients) suffered an infectious complication with a microbiological diagnosis, requiring hospitalization in 62.1% of the cases. In addition, 39 patients (6.9%) were diagnosed with a tumor until the end of the follow-up, noting that 34.2% of the cases continued on biological therapy after the diagnosis. Likewise, in 25 patients (36.8%) this infection forced discontinuation of biological treatment. Finally, 10 patients stopped biological treatment due to a serious adverse reaction to it Conclusion Response rates to biological treatment in elderly patients are similar to those described in the general population, with approximately one third of failures happening during the first year. However, a remarkable proportion of patients developed a serious adverse effect that could be related to treatment

Machine Learning Predictive Outcomes Modeling in Inflammatory Bowel Diseases

2021 ◽  
Author(s):  
Aamir Javaid ◽  
Omer Shahab ◽  
William Adorno ◽  
Philip Fernandes ◽  
Eve May ◽  
...  
Keyword(s):  
Machine Learning ◽  
Inflammatory Bowel Diseases ◽  
Clinical Laboratory ◽  
Predictive Analytics ◽  
Data Sets ◽  
Limited Data ◽  
Clinical Implementation ◽  
Bowel Diseases ◽  
Biologic Response ◽  
Inflammatory Bowel

Abstract There is a rising interest in use of big data approaches to personalize treatment of inflammatory bowel diseases (IBDs) and to predict and prevent outcomes such as disease flares and therapeutic nonresponse. Machine learning (ML) provides an avenue to identify and quantify features across vast quantities of data to produce novel insights in disease management. In this review, we cover current approaches in ML-driven predictive outcomes modeling for IBD and relate how advances in other fields of medicine may be applied to improve future IBD predictive models. Numerous studies have incorporated clinical, laboratory, or omics data to predict significant outcomes in IBD, including hospitalizations, outpatient corticosteroid use, biologic response, and refractory disease after colectomy, among others, with considerable health care dollars saved as a result. Encouraging results in other fields of medicine support efforts to use ML image analysis—including analysis of histopathology, endoscopy, and radiology—to further advance outcome predictions in IBD. Though obstacles to clinical implementation include technical barriers, bias within data sets, and incongruence between limited data sets preventing model validation in larger cohorts, ML-predictive analytics have the potential to transform the clinical management of IBD. Future directions include the development of models that synthesize all aforementioned approaches to produce more robust predictive metrics.

scholarly journals Diagnostic Markers for Nonspecific Inflammatory Bowel Diseases

2018 ◽  
Vol 2018 ◽  
pp. 1-16 ◽  
Author(s):  
Alicja Derkacz ◽  
Pawel Olczyk ◽  
Katarzyna Komosinska-Vassev
Keyword(s):  
Disease Activity ◽  
Inflammatory Bowel Diseases ◽  
Clinical Laboratory ◽  
Correct Diagnosis ◽  
Response To Therapy ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Laboratory Biomarkers ◽  
Diagnostic Sensitivity And Specificity ◽  
Noninvasive Biomarkers

The nonspecific inflammatory bowel diseases (IBD) represent a heterogeneous group of chronic inflammatory disorders of the gastrointestinal tract, and Leśniowski-Crohn’s disease (CD) and ulcerative colitis (UC) are among the two major clinical forms. Despite the great progress in understanding the pathogenesis of these diseases, their etiology remains unclear. Genetic, immune, and environmental factors are thought to play a key role. The correct diagnosis of nonspecific inflammatory bowel diseases as well as the determination of disease activity, risk stratification, and prediction of response to therapy still relies on a multidisciplinary approach based on clinical, laboratory, endoscopic, and histologic examination. However, considerable effort has been devoted to the development of an accurate panel of noninvasive biomarkers that have increased diagnostic sensitivity and specificity. Laboratory biomarkers useful in differentiating IBD with functional disorders and in evaluating disease activity, prognosis, and treatment selection for IBD are presented in this study.

scholarly journals Holistic Approach in Cases of irritable Bowel Syndrome

2021 ◽  
Vol 5 (3) ◽  
pp. 01-04
Author(s):  
Hayriye Alp
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Diseases ◽  
Intestinal Inflammation ◽  
Clinical Laboratory ◽  
Holistic Approach ◽  
Mucosal Healing ◽  
Treatment Modalities ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Inflammatory Bowel Diseases (IBD), which starts with intestinal inflammation and mucosal tissue damage, progresses with an impaired immune response, causes intestinal and extraintestinal symptoms, whose etiology is unknown, and which systemic chronic diseases that significantly affect their quality of life. Diseases. The mainstay of treatment in IBD is the elimination of symptoms, remission is achieved by mucosal healing, maintenance of remission and prevention of recurrence.The aim of treatment in IBD is to improve clinical laboratory, mucosal and quality of life. Conventional treatment for the disease.It is not sufficient to correct related complications. Therefore, new treatment modalities should be initiated as early as possible. From a modern medical perspective, inflammatory bowel diseases are nowadays often referred to as autoimmune diseases.It is accepted. To find the right individual remedy, inflamed bowel It is also important to look at possible causes of the disease. Because In the Regulatory Medicine approach, holistic healing is by eliminating the causes, not by suppressing or treating the symptoms best done by removing.

scholarly journals Biosimilar biological drugs in the treatment of inflammatory bowel diseases

2019 ◽  
Vol 14 (4) ◽  
pp. 223-227
Author(s):  
Magdalena Kaniewska ◽  
Piotr Eder ◽  
Anita Gąsiorowska ◽  
Maciej Gonciarz ◽  
Jarosław Kierkuś ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Biological Drugs ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Biosimilars for the Management of Inflammatory Bowel Diseases: Economic Considerations

2019 ◽  
Vol 26 (2) ◽  
pp. 259-269 ◽  
Author(s):  
Laszlo Gulacsi ◽  
Marta Pentek ◽  
Fanni Rencz ◽  
Valentin Brodszky ◽  
Petra Baji ◽  
...  
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Health Gain ◽  
Cost Savings ◽  
Population Level ◽  
Biological Drugs ◽  
Access To Treatment ◽  
Key Stakeholders ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Economic Considerations

Biological drugs revolutionized the treatment of inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis. However, not all clinically eligible patients have access to biologicals due to significant costs and budget impact. Biosimilars are highly comparable to their originator product in terms of clinical efficacy and safety. Biosimilars are priced 15-75% lower than their reference product, which makes them a less costly alternative and is expected to offer better patients access to biologicals. The total projected cost savings are significant. </P><P> If the achieved budget savings were used to cover more biological therapy, several additional IBD patients could be treated. Currently, the main barriers to the increasing uptake of biosimilars are the few incentives of the key stakeholders, while physicians’ and patients’ skepticism towards biosimilars seems to be changing. Over the coming years, biosimilars are expected to gain a growing importance in the treatment of IBD, contributing to a better access to treatment, improving population-level health gain and sustainability of health systems. This review summarizes the results of the literature on the economic considerations of biosimilars in IBD and the role of biosimilar infliximab in the treatment of IBD.

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