“Predicting response to therapy in inflammatory bowel diseases ”

As available treatment options for inflammatory bowel disease are rapidly increasing, biomarkers predicting response to treatment have to be identified in an attempt to achieve individualized medicine. Similar to the oncology field, biomarker development will only move forward by applying genomics, proteomics, transcriptomics, metagenomics and/or metabolomics, and integrate these with clinical, endoscopic, histological and radiological findings. With this project, we will first study if proteins (biomarkers) in the blood, measured just before start of a new therapy via mass spectrometry in 500 IBD patients can help to predict which patients will benefit most from a particular drug. Finding a blood-based marker would be particularly good as this is easy to study and measure. Although we discovered already several transcriptomic biomarkers at the mucosal level, patients prefer blood tests instead of mucosal biopsies. Therefore, whole blood (surrogate) transcriptomic biomarkers, reflecting formerly identified tissue or peripheral blood mononuclear cells-derived biomarkers, are eagerly awaited, especially as they would be easily to implement in daily clinical practice. Additionally, we will study whether the combination of those transcriptomic and proteomic data, together with the host’s genome (genomics), the microbiome (metagenomics) and the immune system will further improve the accuracy of predicting the therapeutic response of biological agents. This project will deliver a biomarker panel, enabling a more accurate prediction of (non)response to anti-TNF therapy, vedolizumab, ustekinumab and/or tofacitinib in patients with Crohn’s disease and ulcerative colitis. Instead of a ‘one-size fits all principle’, this biomarker panel will provide a more personalised approach in individual patients. Even if we can identify a biomarker panel which predicts non-response to a particular drug, this is also very important as it would prevent un-necessary use of drugs with a very low likelihood of leading to improvement of patients