Challenges in Managing Immune-Mediated Inflammatory Diseases (IMIDs)
IMIDs affect over 230 million people worldwide (Gelabert-Mora et al., 2024). These chronic conditions span multiple specialties, including rheumatology, dermatology, and gastroenterology, and are often accompanied by chronic fatigue, reduced quality of life, and increased risk of comorbidities. While they present differently—affecting joints, skin, or the gastrointestinal tract—they share a common root cause: immune system dysregulation (McInnes & Gravallese, 2021). This is frequently managed by similar immunosuppressive therapies, which aim to control symptoms, inflammation and disease progression.
Despite these shared characteristics, research efforts have largely remained siloed within individual specialties. This fragmented approach limits collaboration and slowed down progress towards more integrated, patient-centered care. Most clinical trials are short-term and disease-specific, offering limited insight into long-term effects across different IMID populations (Dang, 2023). Consequently, our understanding of disease progression and the development of comorbidities that may require co-medication remains incomplete. As a result, clinicians and patients often lack clear, evidence-based guidance on managing the real-world effects of immunosuppressive therapies. Although existing retrospective and real-world studies provide valuable insights into variability in treatment responses, they often fall short in capturing comorbidity impacts, frequently involve limited sample sizes or regional constraints, and may not consistently document the effects of co-medication (Dang, 2023).
The challenge is further compounded by the diversity in patient related factors. Heterogeneity in age, comorbidities, and immune system dynamics make it difficult to generalise treatment effects. To improve outcomes without compromising treatment effectiveness, personalised approaches based on immune system profiles and longitudinal monitoring are increasingly necessary (Delhalle et al., 2018).
Current IMID Treatments
Therapeutic strategies to manage IMIDs focus on immune-targeted interventions that modulate shared dysregulated molecular pathways (McInnes & Gravallese, 2021). These include tumor necrosis factor (TNF) inhibitors, IL-17, IL12/23 signaling axis, interferon-mediated responses, and the IL-6 pathway.
Every new therapy, or a new indication for an existing therapy, must show a positive benefit/risk ratio based on extensive clinical trials, which are typically conducted in sequential phases, each with predefined objectives and endpoints. However, despite their rigorous design, clinical trials often involve carefully selected populations based on strict inclusion and exclusion criteria and typically feature limited follow-up durations (Dang, 2023).
Once sufficient evidence has been gathered, the therapy may undergo regulatory review from agencies such as the European Medicines Agency and the U.S. Food and Drug Administration for eventually receiving authorisation for clinical use. At this point, a critical question arises: how will the medication perform in the real-world complex and heterogeneous patient populations? Real-world data (RWD) may bring us closer to the answer.
Despite widespread use of these (new) therapies across indications, the (post-marketing) monitoring of real-world treatment effects remains inconsistent, and are frequently not well reported. This data-gap is enlarged because of the siloed nature of data across medical specialties, making research challenging. Additionally, the lack of harmonisation in processes of healthcare data collection across Europe adds another layer of difficulty to the research.
There is a pressing need for standardised, cross clinical specialty data collection and monitoring frameworks to overcome these challenges. Large-scale, international RWD projects are crucial for enlarging our knowledge of the real-world realities of treating IMIDs.
The IMID Observatory: A Real-World Evidence Solution for Long-Term treatment effects
The IMID Observatory is a collaborative platform developed by LOGEX to enable hospitals and life science partners to work together to optimise long-term treatment in IMID care.
With the Observatory, we are able to:
- Generate insights that help clinicians anticipate and manage patient-specific situations more effectively by aggregating and standardising clinical and immunological data across disciplines and institutions. This data-driven approach supports personalised treatment decisions and promotes more coordinated care across specialties.
By analysis and sharing real-world data, we might tailor treatments for each patient and inform physicians on current daily clinical practice to optimize the care for IMID patients. Interested in learning more? Click here.
To learn more about how you can get involved in the IMID Observatory, reach out to our Real-World Evidence Lead Femke Oldenziel, at femke.oldenziel@logex.com.
References
Gelabert-Mora, A., Chiang, B., Lee, A., Sinha, M., & Abuabara, K. (2024). Global and US trends In Immune Mediated Inflammatory Diseases including psoriasis, atopic dermatitis, multiple sclerosis, inflammatory bowel disease, and rheumatoid arthritis. JAAD International, 18, 177–179. https://doi.org/10.1016/j.jdin.2024.11.003
McInnes, I. B., & Gravallese, E. M. (2021). Immune-mediated inflammatory disease therapeutics: past, present and future. Nature Reviews. Immunology, 21(10), 680–686. https://doi.org/10.1038/s41577-021-00603-1
Dang A. (2023). Real-World Evidence: A Primer. Pharmaceutical medicine, 37(1), 25–36. https://doi.org/10.1007/s40290-022-00456-6
Delhalle, S., Bode, S. F. N., Balling, R., Ollert, M., & He, F. Q. (2018). A roadmap towards personalized immunology. Npj Systems Biology and Applications, 4(1). https://doi.org/10.1038/s41540-017-0045-9
