Personalised Medicine for Ulcerative Colitis

What this research looked at

Biologic medicines are an important treatment option for Ulcerative Colitis. But people respond differently to each biologic. Some people do not respond to biological medicines and may need surgery.

Doctors cannot predict which biologic will work for each person. They use a ‘try and see’ approach. This means they try one biologic and if it does not work, they will try another one. This can mean that some people try several different biologics before either finding one that works for them. It can take a long time. They may also experience side effects while from the different biologics.

This research looked at whether it is possible to predict which biologic will work from the start. This would avoid the 'try and see' approach. 

The researchers have previously found patterns in inflammation in the bowel. These patterns are different from person to person.

This study looked at whether the different patterns could predict which biologics will work best in an individual.

Bowel samples taken from people with Colitis during routine endoscopy Endoscopy uses a long, flexible tube with a camera on the end to look closely at the lining of the gut. The researchers looked for patterns oof inflammation in the bowel samples.  

The researchers asked each person about their experience with Ulcerative Colitis. This included symptoms and wellbeing. They also looked at the of severity of each person’s disease and how well they responded to treatment. The researchers linked the different inflammation patterns to the person’s experience of their condition and their clinical data.

What the researchers found

The researchers created profiles of the inflammation patterns in the bowel samples, called molecular profiles. By comparing the molecular profiles with the clinical data and each person’s experiences, they were able to create groups, called IBD pathotypes. The researchers then looked at which biologic medicines worked best in each group.

The researchers hope that they’ll be able to match future patients to the groups using bowel samples. And then they can offer each patient a biologic medicine that is more likely to work.

What this could mean for people with Colitis

Researchers hope this study will help to develop a personalised approach to treatments. This would mean people with Colitis will not have to wait as long before finding a medicine that works for them. They would get the medicine that is right for them, right from the start.

This research may also help to develop new medicines for people with Colitis. Looking at the different patterns of inflammation may identify new targets. These targets could be used to develop new medicines. This could benefit people who do not respond well to current medicines.

Who is lead this research: Dr Matthias Friedrich, Nuffield Department of Medicine, University of Oxford
Our funding: £76,988.28
Duration: 24 months
Official title of application: Molecular classification of patients with UC to enable personalised medicine - a feasibility cohort study