Review

Review

Toward a Personalized Medicine Approach to the Management of Inflammatory Bowel Disease

  • The American Journal of Gastroenterology (2014) 109, 9941004 (2014)
  • doi:10.1038/ajg.2014.110
  • Download Citation
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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.

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Author information

Affiliations

  1. Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada

    • Mahmoud H Mosli
    • , Reena Khanna
    • , Bandar Al-Judaibi
    •  & Brian G Feagan
  2. Robarts Clinical Trials, Robarts Research Institute, London, Ontario, Canada

    • Mahmoud H Mosli
    • , William J Sandborn
    • , Reena Khanna
    •  & Brian G Feagan
  3. Department of Medicine, Division of Gastroenterology, King Abdulaziz University, Jeddah, Saudi Arabia

    • Mahmoud H Mosli
  4. Division of Gastroenterology, University of California San Diego, La Jolla, California, USA

    • William J Sandborn
  5. Department of Medicine, Division of Clinical Pharmacology, Western University, London, Ontario, Canada

    • Richard B Kim
  6. Department of Medicine, Division of Gastroenterology, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia

    • Bandar Al-Judaibi

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Competing interests

Guarantor of the article: Brian G. Feagan, MD.

Specific author contributions: M.H.M.: contributed to the paper's concept and intellectual content, performed the literature review, drafted, critiqued, and revised the article; B.J., R.B.K., R.K., W.J.S., and B.G.F.: contributed to the paper's concept and intellectual content, critiqued, and revised the article.

Financial support: None.

Potential competing interests: Reena Khanna has received speaker's fees from Takeda. Professor Sandborn has received consulting fees from AbbVie, ActoGeniX NV, AGI Therapeutics, Alaven Pharmaceuticals, Alba Therapeutics, Albireo, Alfa Wasserman, Amgen, AM-Pharma BV, Anaphore, Astellas Pharma, Athersys, Atlantic Healthcare, Axcan Pharma, BioBalance, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celek Pharmaceuticals, Cellerix SL, Centocor, Cerimon Pharmaceuticals, ChemoCentryx, CoMentis, Cosmo Technologies, Coronado Biosciences, Cytokine Pharmasciences, Eagle Pharmaceuticals, Eisai Medical Research, ELAN, EnGene, Eli Lilly, Enteromedics, Exagen Diagnostics, Ferring, Flexion Therapeutics, Funxional Therapeutics, Genzyme, Genentech, Gilead Sciences, Given Imaging, GlaxoSmithKline, Human Genome Sciences, Ironwood Pharmaceuticals, KaloBios Pharmaceuticals, Lexicon Pharmaceuticals, Lycera, Merck Research Laboratories, MerckSerono, Millennium, Nisshin Kyorin Pharmaceuticals, Novo Nordisk, NPS Pharmaceuticals, Optimer Pharmaceuticals, Orexigen Therapeutics, PDL Biopharma, Pfizer, Procter and Gamble, Prometheus Laboratories, ProtAb Limited, Purgenesis Technologies, Receptos, Relypsa Inc, Salient Pharmaceuticals, Salix Pharmaceuticals, Santarus, ScheringPlough, Shire Pharmaceuticals, Sigmoid Pharma, Sirtris Pharmaceuticals, SLA Pharma (UK), Targacept, Teva Pharmaceuticals, Therakos, Tillotts Pharma AG, TxCell SA, UCB Pharma, Viamet Pharmaceuticals, Vascular Biogenics, Warner Chilcott and Wyeth. He has received lecture fees from AbbVie, Bristol-Myers Squibb, and Janssen. He has received research support from AbbVie, Bristol-Myers Squibb, Genentech, GlaxoSmithKline, Janssen Biotech, Millennium Pharmaceuticals, Novartis, Pfizer, Procter & Gamble, Shire Pharmaceuticals, and UCB Pharma. Brian G. Feagan has received payment for development of educational presentations, including service on the speakers' bureau for Abbott/AbbVie, JnJ/Janssen, Takeda, Warner-Chilcott, UCB Pharma. He has received travel/accommodation compensation from Abbott/AbbVie, Actogenix, Albireo Pharma, Amgen, Astra Zeneca, Avaxia Biologics Inc., Axcan, Baxter Healthcare Corp., Boehringer-Ingelheim, Bristol-Myers Squibb, Calypso Biotech, Celgene, Elan/Biogen, EnGene, Ferring Pharma, Roche/Genentech, GiCare Pharma, Gilead, Given Imaging Inc., GSK, Ironwood Pharma, Janssen Biotech (Centocor), JnJ/Janssen, Kyowa Kakko Kirin Co Ltd., Lexicon, Lilly, Merck, Millennium, Nektar, Novonordisk, Prometheus Therapeutics and Diagnostics, Pfizer, Receptos, Salix Pharma, Serono, Shire, Sigmoid Pharma, Synergy Pharma Inc., Takeda, Teva Pharma, Tillotts, UCB Pharma, Vertex Pharma, Warner-Chilcott, Wyeth, Zealand, and Zyngenia. He has received compensation for his membership on the scientific advisory boards of Abbott/AbbVie, Amgen, Astra Zeneca, Avaxia Biologics Inc., Bristol-Myers Squibb, Celgene, Centocor Inc., Elan/Biogen, Ferring, JnJ/Janssen, Merck, Novartis, Novonordisk, Pfizer, Prometheus Laboratories, Salix Pharma, Takeda, Teva, Tillotts Pharma AG, and UCB Pharma. The remaining authors declare no conflict of interest.

Corresponding author

Correspondence to Brian G Feagan.