Personalizing IBD Therapy: The Asian Perspective

Abstract

Background: All patients with inflammatory bowel disease (IBD) share common therapeutic goals, such as complete mucosal healing and improved long-term outcomes (e.g., reduction in hospitalization, surgery and mortality). However, because IBD patients have diverse features in terms of severity, phenotypes, clinical courses and responses to therapy, therapeutic options for achieving these goals differ among patients, from no therapy to early introduction of combination therapy with anti-TNF and immunosuppressive agents. Key Messages: By personalizing IBD therapy, we may be able to maximize management efficacy, minimize the risk of adverse events and ultimately decrease costs. The initial steps of personalized therapy involve the selection of the right patients by predicting the clinical course of IBD and the subsequent selection of the right therapy by predicting the response to therapy. The next step of personalized therapy involves the adjustment of therapy through therapeutic response evaluation and therapeutic drug monitoring. Notably, current recommendations on personalized IBD therapy are mainly based on results derived from Western populations. However, Asian patients with IBD are different from Western patients in many respects, including clinical characteristics, therapeutic response and prognosis, probably due to differences in environmental and genetic backgrounds. In addition, the healthcare systems and sociocultural backgrounds of Asian countries are not the same as those of Western countries. Therefore, personalized IBD therapy for Asians may differ from that for Westerners in some aspects. Conclusions: This review discusses the current progress of personalized IBD therapy and its application from the Asian perspective.