New insights into biopharmaceuticals in the treatment of IBD
By studying Swedish patient data, Örebro researcher Isabella Visuri has identified new patterns in how biopharmaceuticals affect patients with inflammatory bowel disease (IBD), shedding new light on treatment effects, safety and the ability to predict which patients are most likely to succeed with their treatment.
Integrin-inhibiting drugs prevent white blood cells from travelling to specific sites in the body. For example, the drug vedolizumab is designed to suppress inflammation in the gut selectively.
In her thesis, Isabella Visuri investigated how biopharmaceuticals work by examining four comprehensive observational studies based on Swedish patient data. They also examined whether various blood markers could predict the outcome of IBD patients receiving a particular drug.
Treatment efficacy and persistence - key differences between pharmaceuticals
The research shows that the treatment duration differed between anti-TNF drugs such as infliximab and adalimumab. These are biopharmaceuticals in which antibodies are directed against specific parts of the immune system. Because intestinal inflammation is suppressed by the medicine, the challenge is knowing which treatment is appropriate for the individual patient.
"The variations may depend on the patient's state of health at the beginning of the treatment and on the properties of the drugs themselves," says Isabella Visuri, a physician in the field of laboratory medicine and a recent PhD at Örebro University.
Results for the drug golimumab showed that almost half of the patients were still on the medicine one year after initiating treatment, with improvements in both inflammation markers and quality of life.
"Long-term use of the integrin inhibitor vedolizumab was also shown to work well in patients who initially responded to treatment, paving the way for further long-term treatment options."
Blood markers as a tool in the future
Among the patients studied, several blood proteins coincided with drug concentrations at follow-up. Isabella Visuri considers this worth further study to determine whether the findings can be confirmed in other patient groups.
"These discoveries could pave the way for more personalised treatment in the future, involving optimising drug doses to suit individual patient needs," says Isabella Visuri.
One of the more surprising findings was a variation in how long patients continued on different anti-TNF drugs. This could provide valuable insight into why certain treatments work better for some patients.
"However, the most encouraging finding is that patients who previously failed to respond to one bio-drug may benefit from another, offering new promise for many people with chronic bowel disease.
Help in everyday clinical practice
Researchers' work is contributing to addressing gaps in knowledge about how biopharmaceuticals are used in the real world, outside the controlled environments of clinical trials. One aim is that the results will help healthcare professionals make more informed choices and contribute to developing national guidelines.
"It's crucial to study patients previously treated with biopharmaceuticals, as these groups are often excluded from clinical trials. Our research shows that these patients may also benefit from treatment in the long term," she says.
With insight from the Swedish IBD quality registry, SWIBREG, which covers 65,000 patients, these studies are shaping the future of patient care for inflammatory bowel disease. New knowledge can improve treatment, quality of life, and more personalised care.
Text: Elin Abelson
Photo: Maria Bergman
Translation: Jerry Gray