Shifting towards personalized treatment approaches for chronic inflammatory diseases

Chronic inflammatory diseases affect 5% to 7% of the population, regardless of age or sex, from children to the elderly. Chronic inflammatory diseases encompass a range of conditions. The most common inflammatory diseases include rheumatoid arthritis, Crohn's disease, psoriasis, and multiple sclerosis among others.

Few of the current therapies for chronic inflammatory diseases are effective and even though some may control the disease, they do not provide a cure. To overcome these problems, researchers and clinicians are focusing on several topics to improve patient care in treatment with therapeutic antibodies.

The landscape of treating chronic inflammatory diseases has seen a significant transformation with the advent of targeted therapies employing therapeutic antibodies. However, a notable segment of patients either do not respond adequately to the treatment or experience a decline in responsiveness over time. This challenge is primarily linked to issues such as suboptimal dosing, immunogenicity, and variations in pharmacokinetics, (how the drugs circulate through the body) among different patients.

In response to this critical need for more effective treatment, researchers have initiated a strategic shift towards personalized treatment approaches. This involves the development of patient stratification tools and leveraging therapeutic drug monitoring (TDM) to tailor dosages based on serum drug concentrations.

The potential for a substantial enhancement in patient care is immense by implementing individualized (TDM-guided) dosing schemes of therapeutic antibodies in routine clinical practice for treating chronic inflammatory diseases. This tailored approach will ultimately lead to more efficient utilization of these valuable but costly drugs, ensuring "the right drug at the right dose for the right patient".

However, Europe faces a challenge in the fragmentation of expertise related to individualized (TDM-guided) treatment optimization. The knowledge and techniques required for effective implementation are concentrated in a limited number of pioneering centers, making dissemination to other centers challenging. Notably, the lack of standardization in TDM assays adds to the complexity.

Introducing ENOTTA COST Action

To address these challenges and foster a more cohesive approach, a comprehensive, interdisciplinary pan-European network is being established. ENOTTA COST Action, which stands for "European Network on Optimising Treatment with Therapeutic Antibodies in chronic inflammatory diseases," brings together 156 experts from 31 countries that include major scientific disciplines, such as medical doctors, basic researchers, biologists, computer scientists, pharmacometricians, patients, small and medium enterprises (SMEs), and health authorities to encompass all aspects of the challenge.

ENOTTA advocates for personalized use of therapeutic antibodies to become the new standard of care for patients with chronic inflammatory diseases."

Prof Denis Mulleman, Chair of ENOTTA

This initiative aims to consolidate and structure scientific research in this domain, fostering collaboration and knowledge exchange. The ultimate goal is to facilitate the seamless integration of individualized (TDM-guided) cost-effective dose optimization of therapeutic antibodies into daily clinical practice for treating chronic inflammatory diseases.

Added value with ENOTTA

Breaking new ground, the ENOTTA COST Action sets out to establish a distinctive framework, unlike any existing initiatives. This innovative initiative is designed to facilitate networking, sustained collaboration, and expansion of partnerships among its participants across Europe.

ENOTTA is poised to catalyze progress in this therapeutic domain, facilitating the exchange of expertise and the wide dissemination of valuable knowledge for the benefit of patients enduring long-standing inflammatory diseases. By promoting scientific collaboration between key players in the European research landscape, this initiative will play a pivotal role in advancing the field of personalized use of therapeutic antibodies. Additionally, it will establish critical connections with leading experts on a global scale.

Taken together, the innovative nature of this Action will come from the ability of the whole group to create tools for patient stratification, assay harmonization, universal standards, and the availability of guidelines and treatment algorithms that are accepted by healthcare insurance, clinicians, and patients. These developments will be crucial for implementing individualized (TDM-based) dose optimization of therapeutic antibodies in daily clinical practice. Ultimately, the optimal use of therapeutic antibodies using TDM will alleviate the burden on the healthcare system. Furthermore, the insights obtained by this Action might also guide future research in other disciplines such as oncology, metabolic and cardiovascular diseases that use therapeutic antibodies.