Exabis Library

In recent decades, there has been a growing appreciation that Inflammatory Bowel Disease (IBD) needs a personalized approach to treatment so that the right therapy can be given to the right patient at the right time. Indeed, the potential benefits of personalized medicine for IBD are evident. One approach may be through prognostic information, which is essential for clinical decision-making, as it provides physicians with substantial evidence that can assist them in guiding patients during their disease and treatment course. Prognostic markers, such as clinical, serological, endoscopy, fecal, and histology factors, predict the natural course of the disease, and their utility is based on the assumption that treatment stratification can impact the course of the disease. Therefore, recent literature has focused on identifying good prognostic models based on genetic/serological or clinical/demographic factors that could substantially contribute to tailoring each patient's treatment and potentially surpass a significant barrier to personalized medicine in IBD due to the lack of algorithms to guide treatment from diagnosis.

This talk will present and summarize the most recent scientific evidence of disease risk factors as prognostic tools in Crohn's disease (CD) and ulcerative colitis (UC) and provide some take-home messages on this topic such as:

-        Patients with CD and UC are so heterogeneous that a single treatment algorithm will never be suitable. Therefore, we need individualized treatment options and decisions.

-        System dynamics analysis is a methodology that addresses the inherent dynamic complexity of interactions between variables. As an alternative to traditional statistical methods, it may have the ability to translate complex clinical data into patient-friendly results.

-        Bayesian networks can be seen as an alternative to logistic regression, where statistical dependence and independence are not hidden in approximating weights but rather explicitly represented by links in a network of variables.

Monica Boirivant describes the work and the thinking behind her team’s demonstration of distinct subgroups of patients with different IL-13 expression in ulcerative colitis, with distinct clinical and microbial profiles and discusses implications for therapeutics in the context of previous negative anti-IL13 studies.

1. To understand the background and benefits of Patient centered care

2. To review the evidence of Patient centered care

3. To learn about both benefits and disadvantages with patient involvement when developing guidelines