In the future, patients will receive personalised treatments for inflammatory bowel diseases. That’s the hope shared by Dr Azucena Salas, principal investigator at the IBD unit in IDIBAPS (Spain), and Dr Max Waldner, Professor at the Gastroenterology Department of Erlangen University Hospital (Germany). Both experts took part on the 27th of April 2020 in an online debate on the future of IBD treatment and diagnosis, streamed live on New Deal’s Twitter feed. “The idea is to establish personal treatments, so patients can be chosen based on their biology and matched with the best drug,” said Dr Salas, who is a principal investigator of New Deal, during the event.

New Deal organised the live forum in partnership with EUPHORIA, another research project funded by the European Commission which aims to make a novel and non-invasive monitoring technique for IBD clinically available. Dr Waldner, a principal investigator of EUPHORIA, explained the benefits of this imaging process, which combines lasers and ultrasound, during the live chat: “By using this non-invasive procedure, you have more objective information about the real disease activity in patients — what you get with ultrasound is information about tissue morphology, but here we really get information about individual molecules.”

 

 

Joining the debate with the experts was Rachel Sawyer, an IBD patient from the UK. Sawyer is an advocate for patient wellbeing and education who shares advice on Crohn’s disease and ulcerative colitis from her Twitter accounts, The Bottom Line and IBD Women’s Health. She provided a patients’ perspective on these cutting-edge developments in treatment and monitoring. “Do patients want to have less invasive procedures? Absolutely yes,” she said. “And less frequent visits to the hospital, particularly at the moment,” Sawyer added, although she did raise the concern that new developments in home-testing kits may cause “hyper-vigilance” in anxious patients.

Approximately 200 viewers tuned in to watch the live stream, which was moderated by Bruno Martin from the science communication company Scienseed, a New Deal partner. The full, 50-minute video is now available on YouTube. The conversation ended on a positive note regarding the prospects of patients, where Dr Salas highlighted the importance of basic research on the road towards personalised medicine. “The more we understand how treatments work, the more we can adjust them to each patient,” she said.

Currently, there is a tendency to repurpose drugs developed for other auto-immune diseases in IBD trials, while few efforts focus on developing new treatments to specifically target the gut. The result is an inexplicable failure of some medicines in some patients, which could be addressed by more detailed knowledge of both the disease biology and the drugs’ mechanisms. “One of the important areas of research, now that we have many therapeutic options, is to understand why some patients fail [to respond to] drugs,” Dr Salas said. “We need to understand how they work. We need to go back to the drawing board.”