Tailoring treatment: a comprehensive review of precision medicine and biological therapies in inflammatory bowel disease

Abstract

Background: Inflammatory Bowel Disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), constitutes chronic immune-mediated disorders of the gastrointestinal tract. Their diverse inflammatory patterns and unpredictable course challenge effective diagnosis and treatment. With escalating global incidence, the evolving landscape of IBD management integrates precision medicine and a burgeoning array of biological therapies, aiming to revolutionize disease interception and personalized treatment strategies. Objectives: Examine the evolving role of precision medicine, genetic markers, biomarkers, and biological therapies in Inflammatory Bowel Disease (IBD) management, assessing their impact on disease prediction, treatment response, and personalized care. Methods and Materials Required: The authors conducted a review as per the SANRA guidelines and searched for literature across PubMed and Google Scholar. RESULTS: Precision medicine and biomarkers redefine Inflammatory Bowel Disease (IBD) management. Genetic markers exhibit limited predictive power, necessitating integration with RNA sequences for refined disease trajectory understanding. Fecal calprotectin emerges as a transformative non-invasive tool for monitoring disease activity. Pharmacogenomics, exemplified by TPMT genotyping, showcases personalized treatment strategies. Anti-TNF-α therapies demonstrate superiority in inducing remission, yet newer agents like vedolizumab offer promising alternatives, especially in anti-TNF-α refractory patients. The evolving landscape of biological therapies signifies a shift towards targeted treatments, underscoring the need for nuanced patient-specific therapeutic approaches in IBD.