Toward a personalized medicine approach to the management of inflammatory bowel disease

Mahmoud H Mosli; William J Sandborn; Richard B Kim; Reena Khanna; Bandar Al-Judaibi; Brian G Feagan

doi:10.1038/ajg.2014.110

Toward a personalized medicine approach to the management of inflammatory bowel disease

Am J Gastroenterol. 2014 Jul;109(7):994-1004. doi: 10.1038/ajg.2014.110. Epub 2014 May 20.

Authors

Mahmoud H Mosli¹, William J Sandborn², Richard B Kim³, Reena Khanna⁴, Bandar Al-Judaibi⁵, Brian G Feagan⁴

Affiliations

¹ 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.
² 1] Robarts Clinical Trials, Robarts Research Institute, London, Ontario, Canada [2] Division of Gastroenterology, University of California San Diego, La Jolla, California, USA.
³ Department of Medicine, Division of Clinical Pharmacology, Western University, London, Ontario, Canada.
⁴ 1] Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada [2] Robarts Clinical Trials, Robarts Research Institute, London, Ontario, Canada.
⁵ 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.

PMID: 24842338
DOI: 10.1038/ajg.2014.110

Abstract

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.

Publication types

Review

MeSH terms

Algorithms
Azathioprine / therapeutic use
Drug Monitoring
Humans
Immunosuppressive Agents / therapeutic use
Inflammatory Bowel Diseases / drug therapy*
Inflammatory Bowel Diseases / enzymology
Inflammatory Bowel Diseases / genetics*
Mercaptopurine / therapeutic use
Methyltransferases / analysis
Precision Medicine*
Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

Immunosuppressive Agents
Tumor Necrosis Factor-alpha
Mercaptopurine
Methyltransferases
thiopurine methyltransferase
Azathioprine