Several aspects of the management of Crohn's disease (CD) are shared between patients.
Dr Séverine Vermeire and colleagues from Belgium reviewed the personalized use of Crohn's disease therapeutic options currently used.
The team report that the goal of all therapies should be to achieve clinical and endoscopic remission in a timely manner to avoid disease progression and abdominal resections.
The researchers acknowledge that the way this goal is achieved may differ.
|Clinicians have started to gain interest in drug level monitoring in an individualized manner|
Predicting how the disease will evolve, what the most appropriate therapy with the highest chance of success will be, how long a therapy needs to be continued, and what the intensity of follow-up should be are more difficult questions and require an individualized approach.
Clinical parameters have been suggested to aid in the therapeutic decision process but lack specificity.
Although much promise has been put in molecular markers, these have not yet found their way to the clinic.
More recently, clinicians have started to gain interest in drug level monitoring to adapt doses of immunomodulators and/or anti-tumor necrosis factor antibodies in an individualized manner.
The team found an increasing number of studies showing that therapeutic drug monitoring can help physicians to improve and personalize the management of their patients.
Dr Vermeire's team concludes, "What is needed now are pharmaco-economic studies showing that personalized management of Crohn's disease is cost effective."