Brighter days ahead: the shifting landscape of IBD therapy

PURPOSE OF REVIEW: The field of inflammatory bowel disease (IBD) continues to evolve at an unprecedented rate as the past decades have borne witness to the complete transformation of our approach to IBD and its care. Despite that, we continue to face major challenges, including rising incidence, shifting demographics, financial toxicity, as well as a frequently encountered therapeutic ceiling. This review aims to highlight the main factors driving the shifting landscape of IBD therapy. RECENT FINDINGS: Many steps are being taken to improve efficacy and raise the therapeutic ceiling. Mounting evidence from clinical trials suggests that the use of various dual advanced therapies is well tolerated and may increase overall efficacy. Novel therapeutic mechanisms are being explored, including various novel oral agents as well as antihuman tumor necrosis factor-like cytokine A (anti-TL1A) antibodies with their novel antifibrotic potential. Delivery of care is also being optimized and refined with greater emphasis on early diagnosis, early effective therapy, treating to target and monitoring objective outcomes, therapeutic drug monitoring, and more effective use of current therapies. Greater recognition of the impact of IBD on patients beyond the disease itself is driving the spread of a patient-centric, multidisciplinary team-based approach to IBD care. SUMMARY: As we continue to refine and deepen our understanding of IBD, the landscape of IBD therapy continues to shift and evolve as it aims to meet the needs of IBD patients with hope for brighter days ahead.