P1167 Treatable traits (TTs) approach in the management of Inflammatory Bowel Disease: a new concept
Authors: Facanali C , Sobrado C W , RF Carvalho C 
Published: January 2025

Background

Inflammatory bowel diseases (IBD) are highly prevalent and complex chronic conditions that affect the digestive tract and induce extra-intestinal manifestations and numerous comorbidities. Distinct IBD phenotypes and clinical manifestations differ individually1. The pathogenesis of the disease is complex and requires personalized therapies2. The World Health Organization (WHO) recommends a holistic approach that is defined as "perfect physical, mental and social well-being." “Treatable traits" (TT) is a personalized and multidimensional precision medicine approach created primarily to deal with the complexity and heterogeneity of chronic and complex conditions. Initially proposed for treating respiratory diseases, it has expanded to other areas3. The present abstract aims to shed light on, identify, and define the most prevalent TTs applied to IBD.

Methods

TTs were identified according to their clinical relevance and the possibility of being modifiable, enabling personalized and individualized treatment targeting. They were subdivided into three main domains following the concept of TT in IBD. Adopting the TT concept will be useful in primary health care and tertiary centers to aim for disease control, avoiding exacerbations, and maximizing results, as demonstrated in other diseases4.

Results

Gastrointestinal or intrinsic TTs are composed of laboratory investigations (biomarkers), endoscopic and radiological, to identify the phenotypic characteristics and the degree of inflammatory activity.

Extra-intestinal TT: The main ones are rheumatological, dermatological, ophthalmological, and hematological. It is important to emphasize that many of these extra-intestinal manifestations appear as comorbidities.

Psychological and behavioral TT: based on the patient's lifestyle and behavior and include obesity and malnutrition, diet and nutrients, smoking, sedentary lifestyle and physical activity, sleep quality, fatigue, adherence to treatment, and family support network) as well as the mental health including anxiety, depression, and suicidal ideation.

The list of treatable characteristics is limited by the knowledge of the interactions identified to date and will expand as they are identified and targeted treatments approved by ECCO.

Conclusion

The definition and identification of TT in IBD are feasible and reported for the first time. Treatment based not only on pharmacological treatment aimed at mucosal healing and improves to address the limitations of existing treatment strategies to date. The holistic approach proposed by the authors will benefit not only in improving patients' QoL but also in providing a more effective, sustained, and long-lasting response.

References

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