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Treatment sequencing in inflammatory bowel disease: Towards clinical precision medicine

Léa Sequier1, Bénédicte Caron2, Sailish Honap3

  • 1Department of Gastroenterology and Hepatology, Nîmes University Hospital, Carémeau Hospital, Nîmes, France; Department of Gastroenterology and Hepatology A, Saint-Éloi Hospital, Montpellier, France.

Best Practice & Research. Clinical Gastroenterology
|August 6, 2025
PubMed

Insights

Optimizing treatment sequencing for inflammatory bowel diseases (IBD) is crucial. Personalized strategies considering patient factors and disease characteristics improve outcomes and quality of life.

Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Pharmacology

Background:

  • Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, present complex clinical management challenges.
  • Variable disease courses and impact on quality of life necessitate advanced therapeutic approaches.
  • The development of biologics and small molecules requires effective treatment sequencing strategies.

Purpose of the Study:

  • To review current insights into treatment sequencing for IBD.
  • To explore criteria for optimizing therapeutic choices in IBD management.
  • To highlight the need for personalized treatment strategies.

Main Methods:

  • Literature review of advanced therapies in IBD.
  • Analysis of treatment sequencing based on clinical criteria.
  • Examination of patient-specific factors influencing treatment selection.

Main Results:

  • No definitive algorithm exists for IBD treatment sequencing.
  • Physicians currently tailor treatments based on individual patient profiles.
  • Key factors include prior anti-TNF alpha agent use, surgery history, disease phenotype, and patient comorbidities.

Conclusions:

  • Personalized treatment sequencing in IBD is essential for improving long-term outcomes.
  • Tailoring therapy to individual patient characteristics and response history enhances management.
  • Further research is needed to refine and integrate advanced sequencing strategies into clinical practice.
Keywords:
Advanced therapiesCrohn's diseaseSequencingUlcerative colitis

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