Precision medicine: Are we ready in IBD?

Inflammatory bowel diseases are progressively increasing their prevalence worldwide, affecting approximately 6 million patients. Although the therapeutic armamentarium is continuously expanding, approximately one-third of patients are primary non-responders to initial treatment and up to half of patients will have an incomplete or loss of response over time. It is well-established that the IBD-associated tissue damage process is induced by an exaggerated immune response against luminal antigens and that it is favoured by a genetic predisposition and environmental factors, while aetiology remains unclear. By mirroring the extraordinary advance obtained in oncology, a “precision medicine” approach is under active investigation in IBD to achieve better risk stratification and better identification of patients more likely to respond to a specific therapy as well as to minimise adverse effects and foster better clinical decision-making. In this short review, we will briefly mention the available experiences in IBD and the limits and challenges of precision medicine in this field, illustrating why it is still not ready for prime time.