The challenges of stratifying patients for trials in inflammatory bowel disease

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• 作者：Paolo Biancheri ; Nick Powell ; Giovanni Monteleone ; Graham Lord ; Thomas T. MacDonald
• 关键词：biological therapy ; biomarker ; disease heterogeneity ; tumor necrosis factor-伪
• 刊名：Trends in Immunology
• 出版年：November, 2013
• 年：2013
• 卷：34
• 期：11
• 页码：564-571
• 全文大小：641 K

文摘

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.