Toward a personalized medicine approach to the management of inflammatory bowel disease.
The medical management of inflammatory bowel disease (IBD) is evolving toward a personalized medicine-based model. Modern therapeutic algorithms that feature use of tumor necrosis factor (TNF) antagonists in combination with immunosuppressive are highly effective when initiated in high-risk patients early in the course of disease. Defined targets that guide intensification of therapy are critical interventions. In this model, therapy is optimized through appropriate pretreatment testing, therapeutic drug monitoring, and patient-based monitoring strategies. This review discusses the current application of personalized medicine to the management of IBD.
1] Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada [2] Robarts Clinical Trials, Robarts Research Institute, London, Ontario, Canada [3] Department of Medicine, Division of Gastroenterology, King Abdulaziz University, Jeddah, Saudi Arabia.
Mahmoud H
MH
Mosli
1] Robarts Clinical Trials, Robarts Research Institute, London, Ontario, Canada [2] Division of Gastroenterology, University of California San Diego, La Jolla, California, USA.
William J
WJ
Sandborn
Department of Medicine, Division of Clinical Pharmacology, Western University, London, Ontario, Canada.
Richard B
RB
Kim
1] Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada [2] Robarts Clinical Trials, Robarts Research Institute, London, Ontario, Canada.
Reena
R
Khanna
1] Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada [2] Department of Medicine, Division of Gastroenterology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Bandar
B
Al-Judaibi
1] Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada [2] Robarts Clinical Trials, Robarts Research Institute, London, Ontario, Canada.
Brian G
BG
Feagan
D000465:Algorithms; D001379:Azathioprine / Q000627:therapeutic use; D016903:Drug Monitoring; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics*; D015122:Mercaptopurine / Q000627:therapeutic use; D008780:Methyltransferases / Q000032:analysis; D057285:Precision Medicine; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D015122:Mercaptopurine; D008780:Methyltransferases; C022745:thiopurine methyltransferase; D001379:Azathioprine