Predictors of non-response to ongoing conservative therapy in patients with inflammatory bowel disease

Abstract

Crohn’s disease (CD) and ulcerative colitis (UC), which are part of the group of inflammatory bowel diseases (IBD), belong to the group of immune-mediated diseases and characterized by a chronic relapsing and chronically continuous course, which leads to serious exacerbations and consequences. Patients may undergo radical surgery, often for drug-resistant disease, and the costs associated with IBD are significant and rising. Over the past two decades, there has been a paradigm shift in the treatment of IBD. The therapeutic goal has shifted from eliminating symptoms alone to achieving combined (symptomatic and endoscopic) remission, which is associated with better outcomes, including a lower risk of relapse, need for corticosteroids, hospitalization, colectomy, and colorectal neoplasia. Despite all the successes, the trend of non-response to ongoing conservative therapy continues. Most studies monitor through endoscopic evaluation and a small number of laboratory tests. There is an important need to understand how noninvasive biomarkers can serve as accurate and reliable indicators for assessing inflammation and predictors of lack of response to therapy. The purpose of this publication is to provide evidence on the use of biomarkers to assess disease activity and predictors of non-response to therapy in patients with IBD.