| The disease courses of IBD are variable. Some patient showed more aggressive disease than others characterized by unremitting disease, need for drug escalation or surgery. Current treatment standard is step-up approach that involves how severe patient's symptoms are and start with 5ASA and/or steroid, then immunomodulators and biologics. 50% of patients will experience severe complications including stricture or fistula requiring surgery. About 30% of patients do not respond to biologics. And 15% of responders loose response every year. Prediction of response based on objective biomarkers is necessary to deliver the right drug, right dose, right time to right patient and to avoid unnecessary exposure to ineffective therapy. Longer disease duration, small bowel involvement, smoking and normal CRP level are proposed as clinical predictors of non-response to anti-TNF therapy. However, these factors are not enough to predict prognosis for a specific patient at diagnosis. So, unmet needs of IBD are early detection of patients with potentially aggressive disease & complicated disease courses and prediction of response to therapy. So, doctors can decide the best treatment options based on clinical and biological characteristics of patients, which fits the concept of precision medicine. I will show you current advances and challenges in multi-OMICs studies to predict prognosis and response to therapy in IBD patients. And, finally, I will briefly introduce my current research work using multi-OMICs approach to predict poor prognosis in CD patients called IMPACT study. |
