ADVANCES AND CHALLENGES IN THE TREATMENT OF INFLAMMATORY BOWEL DISEASES: A SYSTEMATIC REVIEW

Abstract

Objective: To understand the aspects of inflammatory bowel diseases, seeking to identify the best screening, treatment, and prevention strategies to improve patients' clinical outcomes. The guiding question, formulated based on the PVO (Population, Variable and Objective) strategy, is: "What are the best treatment and prevention strategies to improve clinical outcomes in patients with inflammatory bowel diseases?" Methodology: Literature review, using the PubMed database, with the descriptors combined with the Boolean term "AND": Inflammatory Bowel Diseases, Biological Therapy, Immunosuppressive Therapies, Crohn's Disease. The search strategies applied were: (Inflammatory Bowel Diseases) AND (Biological Therapy) AND (Immunosuppressive Therapies), (Crohn's Disease) AND (Immunosuppressive Therapies), and (Crohn's Disease) AND (Biological Therapy). A total of 369 articles were identified. After applying the inclusion and exclusion criteria, 41 studies were selected for analysis and 11 of these were selected to compose the collection. The inclusion criteria considered articles in English, Portuguese, and Spanish, published from 2019 to 2024, which addressed the themes proposed for this research; and review, observational and experimental studies, available in full. The exclusion criteria eliminated duplicate articles, available only in abstract form, that did not directly address the proposal studied or that did not meet the inclusion criteria. Results: Appropriate screening and treatment strategies are essential for the prevention of complications of inflammatory bowel diseases. Selected studies have highlighted that the correct use of biological and immunosuppressive therapies is effective in maintaining clinical remission and reducing inflammation. In addition, personalization of treatment based on therapeutic drug monitoring (TDM) and genomic testing can significantly improve patients' clinical outcomes. Conclusion: Early identification and treatment of inflammatory bowel diseases are essential to prevent associated complications and improve patients' quality of life. Effective screening strategies, adequate follow-up, and health education are key to reducing the incidence of these diseases and improving clinical outcomes. Health policies tailored to the needs of vulnerable populations and the strengthening of surveillance systems are crucial to achieving these goals.