Challenges in IBD Research: Precision Medicine

Denson LA1, Curran M2, McGovern DPB3, Koltun WA4, Duerr RH5, Kim SC6, Sartor RB7, Sylvester FA8, Abraham C9, de Zoeten EF10, Siegel CA11, Burns RM12, Dobes AM13, Shtraizent N13, Honig G13, Heller CA13, Hurtado-Lorenzo A13, Cho JH14. Inflamm Bowel Dis. 2019 May 16;25(Supplement_2):S31-S39. doi: 10.1093/ibd/izz078.


Author information

Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Janssen Research and Development, Spring House, PA, USA.

Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Department of Surgery, Division of Colon and Rectal Surgery, Pennsylvania State University, Hershey, PA, USA.

Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA.

Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.

Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.

Division of Pediatric Gastroenterology, University of North Carolina at Chapel Hil, Chapel Hill, NC, USA.

Yale University, New Haven, CT, USA.

10 University of Colorado School of Medicine, Childrens Hospital Colorado, Aurora, CO, USA.

11 Dartmouth Hitchcock Medical Center, Section of Gastroenterology and Hepatology, Lebanon NH, USA.

12 Nuffield Department of Population Health, University of Oxford, Oxford, UK.

13 Crohn's & Colitis Foundation, New York, NY, USA.

14 Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.


Precision medicine is part of five focus areas of the Challenges in IBD research document, which also includes preclinical human IBD mechanisms, environmental triggers, novel technologies, and pragmatic clinical research. The Challenges in IBD Research document provides a comprehensive overview of current gaps in inflammatory bowel diseases (IBD) research and delivers actionable approaches to address them. It is the result of a multidisciplinary input from scientists, clinicians, patients, and funders, and represents a valuable resource for patient centric research prioritization. In particular, the precision medicine section is focused on highlighting the main gap areas that must be addressed to get closer to treatments tailored to the biological and clinical characteristics of each patient, which is the aim of precision medicine. The main gaps were identified in: 1) understanding and predicting the natural history of IBD: disease susceptibility, activity, and behavior; 2) predicting disease course and treatment response; and 3) optimizing current and developing new molecular technologies. Suggested approaches to bridge these gaps include prospective longitudinal cohort studies to identify and validate precision biomarkers for prognostication of disease course, and prediction and monitoring of treatment response. To achieve this, harmonization across studies is key as well as development of standardized methods and infrastructure. The implementation of state-of-the-art molecular technologies, systems biology and machine learning approaches for multi-omics and clinical data integration and analysis will be also fundamental. Finally, randomized biomarker-stratified trials will be critical to evaluate the clinical utility of validated signatures and biomarkers in improving patient outcomes and cost-effective care.

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