TY - JOUR
T1 - The challenges of stratifying patients for trials in inflammatory bowel disease
AU - Biancheri, Paolo
AU - Powell, Nick
AU - Monteleone, Giovanni
AU - Lord, Graham
AU - MacDonald, Thomas T.
PY - 2013/11
Y1 - 2013/11
N2 - Immunotherapy with biological agents or small molecules is revolutionising the treatment of chronic inflammatory disease in humans; however, a significant proportion of patients fail to respond or lose responsiveness. This is particularly evident in inflammatory bowel disease (IBD), a group of chronic, immune-mediated disorders of the gastrointestinal tract. Different responsiveness to treatment in IBD can be explained by substantial disease heterogeneity, which is being increasingly recognised by genetic and immunological studies. The current enthusiasm for stratified medicine suggests that it may become possible to identify clinical, immunological, biochemical or genetic biomarkers to target immunotherapy to patients more likely to respond. Here, we identify and highlight the opportunities and the challenges of this strategy in the context of IBD.
AB - Immunotherapy with biological agents or small molecules is revolutionising the treatment of chronic inflammatory disease in humans; however, a significant proportion of patients fail to respond or lose responsiveness. This is particularly evident in inflammatory bowel disease (IBD), a group of chronic, immune-mediated disorders of the gastrointestinal tract. Different responsiveness to treatment in IBD can be explained by substantial disease heterogeneity, which is being increasingly recognised by genetic and immunological studies. The current enthusiasm for stratified medicine suggests that it may become possible to identify clinical, immunological, biochemical or genetic biomarkers to target immunotherapy to patients more likely to respond. Here, we identify and highlight the opportunities and the challenges of this strategy in the context of IBD.
KW - Biological therapy
KW - Biomarker
KW - Disease heterogeneity
KW - Tumor necrosis factor-α
UR - http://www.scopus.com/inward/record.url?scp=84886947164&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84886947164&partnerID=8YFLogxK
U2 - 10.1016/j.it.2013.08.002
DO - 10.1016/j.it.2013.08.002
M3 - Article
C2 - 24035478
AN - SCOPUS:84886947164
VL - 34
SP - 564
EP - 571
JO - Trends in Immunology
JF - Trends in Immunology
SN - 1471-4906
IS - 11
ER -