News: Testing Genes to predict if Crohn’s Medication will work

When you read the following article your view might depend on your knowledge of statistical methods, false positives, false negatives, and the fact that there are too many mediators and moderators (variables) that could also explain why certain people do not respond or “get better” with certain Crohn’s Disease Medications such as Humira or Remicade.

The DNA Strand and a Doctor testing your genetic code

Here is the link:

https://www.news-medical.net/news/20191007/Common-genetic-variant-explains-why-immunotherapy-often-fails-in-Crohns-disease.aspx

Here are my thoughts:

  1. Getting better is not all or none. This news article that summarizes the journal results fails to mention that any symptom improvement at all in a patient with Crohn’s Disease most likely will IMPROVE Quality of Life.
  2. “Remission” clinically is not the patient telling the doctor that they feel better. Instead remission involves colonoscopy, CT or MRI, blood tests etc. However, it is common and very possible that a person can feel “better or worse” than the test results indicate.
  3. Due to all the potential variables we do not know about I find it a potential dangerous slippery slope for Doctors or Drug companies to deny trying a treatment like Remicade or Humira based on a genetic study. We do not know all the genes involved and even if we do – Genetics always explain about only 50%, the rest is environment, and other social and demographic factors that are UNIQUE to each person.
  4. Crohn’s Disease affects all three layers of the intestine and current tests only look at the outer (on an x-ray, CT, or MRI), or inner (colonoscopy). The middle layer – which could be causing disease symptoms and disability is not being looked at.
  5. Also, the small intestines often cannot be directly looked at on the inside layer even due to narrowing the colonoscopy must stop.
  6. Trust yourself and find a good doctor you trust and work together as a team to find an individualized plan that will work.
  7. Research looks at how events can be predicted in groups – it is unable to predict how an individual will react. Take a look at all the possible side effects or helpful effects of any medication and each individual person will have variability in what happens to them to one degree or another. For example, some people might feel nausea, others might feel fatigue, and another person might feel great!

This is my personal opinion and general scientific information. It is not intended to and cannot replace any advice or recommendations by your healthcare providers. You as a patient should follow medical advice and work with your doctor to make sure your healthcare needs are being met.

Best of luck,

Isaac Levinsky

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