Report on the ECCO Topical Review on Predictive Models on IBD Disease Course and Treatment Response
Michel Adamina, GuiCom Member
 Michel Adamina © ECCO |
The ECCO Topical Review on Predictive Models on IBD Disease Course and Treatment Response was launched in late December 2023 and a virtual kick-off meeting took place in early 2024. At the heart of this Topical Review lies the lack of a trusted model to predict clinical course in IBD patients. Indeed, the wide treatment armentarium available today, with many new drugs and therapeutic classes entering clinical practice, makes decision-making increasingly complex. While the role of medications and surgical options is addressed in the ECCO Guidelines on Therapeutics in Ulcerative Colitis and Crohn’s Disease, prediction of the optimal use and sequence of treatment options remains elusive. Although several biomarkers with the potential to foresee disease course and treatment response have been identified, none has been established in clinical practice. Hence, clinical decision-making relies on dynamic clinical assessment, together with endoscopic evaluation and C-reactive protein and faecal calprotectin measurements.
This Topical Review addresses the development of predictive models to inform and guide the management of IBD patients along a formal framework to assess and report the performance of prediction models and their benefit when compared to real-life clinical decision-making. The unmet clinical needs are at the heart of model development, while methodological aspects and impact studies to consider when building trusted models are addressed.
Julien Kirchgesner and Sophie Restellini serve as coordinators of this Topical Review, which comprises three working groups led by Julien, Sophie and Bram Verstockt specifically addressing:
- Existing predictive models and their implementation in clinical practice
- Appropriate methodology to develop predictive models
- Unmet needs and perspectives on future predictive models
A diverse and interdisciplinary group of 16 experts has searched and appraised the literature following the ECCO standard operative procedures for guidelines creation. They wrote a total of 21 current practice positions and supporting text, which underwent voting and subsequent revision. A final draft will be discussed at a virtual consensus meeting in November, followed by the redaction of the Topical Review manuscript and submission to JCC by the end of 2024. A presentation at ECCO’25 in February is foreseen.