Personalised Medicine for Ulcerative Colitis

What is this research looking at? 

Biologic medicines are one of the main types of treatment for Ulcerative Colitis. But people respond differently to each type of biologic. And some people do not respond to any of them, and surgery may be needed.

Because 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 or opting for surgery. This can be difficult for the person being treated because it can take a long time to find the right treatment for them. They may also experience side effects while trying the different biologics.

The goal of this research is to be able to predict which biologic will work from the start and avoid the ‘try and see’ approach.

In the laboratory the researchers have shown that the patterns of molecules seen in inflammation in the bowel vary from person to person. This study will see if it is possible to use the different patterns of molecules to predict which medicines will work best in an individual. The researchers will look at the different types of inflammation seen in bowel samples taken from people with Ulcerative Colitis during routine endoscopy (an examination of the inside of the body using a tube with a camera in its tip.) They will then link these different molecular patterns to the person’s experience of their condition. The researchers will assess the person’s experience by monitoring their symptoms and well-being and holding group interviews. They will also look at the classification of their disease and how well they respond to treatment.

The next stage of the study will see the researchers testing their idea. They will see if they can use the information from the first part of their study to tailor treatments for individuals. This approach of choosing a treatment based on an individual’s situation is called personalised treatment.

What this could mean for people with Crohn’s and Colitis

This study could help pave the way to personalised treatment for people with Ulcerative Colitis. This would mean people with Ulcerative Colitis will not have to wait as long before finding a treatment 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 Ulcerative Colitis. Looking at the different patterns of inflammation may identify new targets that could be used to develop new medicines. This could benefit people who do not respond well to current medicines.

This project is only studying people with Ulcerative Colitis, but the results may also apply to people with other forms of Inflammatory Bowel Disease.

Who is leading 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