The Current Landscape for Gastroenterology Research
Digestive diseases are a rapidly evolving area of clinical research. The Global GI drug market is projected to grow from $48.74 billion in 2021 to $62.19 billion in 2025. To bring new therapies to market, biopharma companies engage clinical research organizations for fast execution of high-quality clinical trials. ObjectiveHealth provides a research platform second to none in achieving goals of a modern clinical trial. Despite the advances of companies like ObjectiveHealth and optimistic projections, some aspects of gastroenterology and hepatology remain insufficiently investigated. There are unmet needs that require solutions in the future. Some of these areas of focus are suggested below.
Gastrointestinal endoscopy continues to rapidly develop and evolve. Complex invasive procedures are surfacing on an almost daily basis, and the number of potential applications is growing. Future research will need to balance the appropriateness of gastrointestinal endoscopy with clinical indications and evolving techniques.
Knowledge of digestive tract motility has provided motivation for studies that have elucidated the role of the autonomic GI nervous system and visceral hypersensitivity in functional GI disorders from esophagus to colon. This area of research will likely grow.
Non-Alcoholic Fatty Liver Disease (NAFLD)
NAFLD has become the most common liver disease in Western countries. This disease spectrum encompasses a wide range of patients and represents a public health burden of epidemic proportions. Current pharmacologic strategies for treatment of NAFLD and nonalcoholic steatohepatitis, a type of NAFLD that can damage the liver, are multi-pronged, targeting metabolic pathways including insulin hypersensitivity, oxidative stress and fatty acid metabolism. This field of study has rapidly developed due to sheer necessity, and ObjectiveHealth has led the way in this evolving landscape. ObjectiveHealth is currently involved in 14 NASH studies and has emerged as a leader in research engaged in the study and treatment of NAFLD/NASH.
The microbiome is a diverse, complicated and, until recently, poorly understood “organ system.” It is composed of 40 trillion microorganisms and plays a key role in metabolism, gut epithelial health, the immune system and susceptibility to disease. Microbiome research focuses on behavior, interactions and function of microbial communities in a specific environment. The best example of successful research involving the microbiome is the effect Fecal Microbiota Transplantation (FMT) has had on recurrent clostridium difficile infection (CDI). FMT has become the treatment of choice for recurrent CDI; it is efficacious in up to 90% of cases. Going forward, altering the microbiome to treat or decrease the risk of disease may be done more easily than finding therapeutics that rewrite human genes that have been linked to a certain disease. If the premise that the microbiome is a determinant of chronic health issues and disease is true, research on the microbiome will, by necessity, expand exponentially in 2023 and beyond.
Artificial Intelligence (AI)
Finally, integration of AI into gastroenterology and hepatology will almost certainly change the discipline of digestive disease care in the coming years. ObjectiveHealth has employed AI to create disease specific models that curate disease severity, enhance research workflow processes and assist in identifying the right patients for specific trials. AI can truly reduce the time spent on administrative tasks and maximize time spent with the patient (which should be the goal of every provider), and will help present and future GI providers face and overcome obstacles in clinical research and in many aspects of health care more broadly.