A Dynamic Quantitative Systems Pharmacology Model of Inflammatory Bowel Disease: Part 2 - Application to Current Therapies in Crohn's Disease

Clin Transl Sci. 2021 Jan;14(1):249-259. doi: 10.1111/cts.12850. Epub 2020 Aug 21.

Abstract

Inflammatory bowel disease (IBD) is a heterogeneic disease with a variety of treatments targeting different mechanisms. A multistate, mechanistic, mathematical model of IBD was developed in part 1 of this two-part article series. In this paper, application of the model to predict response of key clinical biomarkers following different treatment options for Crohn's disease was explored. Five therapies, representing four different mechanisms of action, were simulated in the model and longitudinal profiles of key clinical markers, C-reactive protein and fecal calprotectin were compared with clinical observations. Model simulations provided an accurate match with both central tendency and variability observed in biomarker profiles. We also applied the model to predict biomarker and clinical response in an experimental, combination therapy of existing therapeutic options and provide possible mechanistic basis for the increased response. Overall, we present a validated, modular, mechanistic model construct, which can be applied to explore key biomarkers and clinical outcomes in IBD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Inflammatory Agents / pharmacology*
  • Anti-Inflammatory Agents / therapeutic use
  • Biomarkers / analysis
  • C-Reactive Protein / analysis
  • Clinical Trials, Phase II as Topic
  • Computer Simulation
  • Crohn Disease / blood
  • Crohn Disease / diagnosis
  • Crohn Disease / drug therapy*
  • Crohn Disease / immunology
  • Drug Therapy, Combination / methods
  • Feces / chemistry
  • Humans
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / immunology
  • Intestinal Mucosa / pathology
  • Leukocyte L1 Antigen Complex / analysis
  • Models, Biological*
  • Molecular Targeted Therapy / methods
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Biomarkers
  • Leukocyte L1 Antigen Complex
  • C-Reactive Protein