The MPS consisted of a colonic 13-gene expression panel. It accurately predicted non-responders, as defined by lack of mucosal improvement, to TNF-antagonist therapy in UC in all 4 independent clinical trials. There was a high negative predictive value of 0.78 in the ACT1 trial, 0.79 in PURSUIT-SC, 0.89 in PROgECT, and 0.73 in PURSUIT-J. In addition, the MPS could predict non-responders, as defined by lack of endoscopic response, to anti-IL-12/23 therapy in the UNITI trial, with a negative predictive value of 0.85. Non-responders, as predicted by MPS, did not differ from predicted responders in baseline disease severity, nor in baseline inflammatory markers including C-reactive protein, faecal calprotectin, or faecal lactoferrin levels. Transcriptomics and microbiome analysis revealed potential ways to treat these predicted non-responders, as they had 268 differentially expressed genes enriched in inflammatory pathways and demonstrated significant microbial dysbiosis. The MPS is now the first prospectively validated predictive biomarker that can accurately identify a discrete subset of non-responder patients to 2 different anti-inflammatory therapies. It may be valuable in identifying subsets of patients in need of treatment with alternative therapies or for patient stratification in clinical trials.
- Sato T, et al. ECCO 2019, OP36.
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Table of Contents: ECCO 2019
Featured articles
Interview with Prof. Janneke van der Woude
New Compounds: Study Results
Short-term and Long-term Treatment Results
The right drug for the right patient
Vedolizumab superior to adalimumab in ulcerative colitis
Complementary and Alternative Medicine
Crohn’s disease exclusion diet + partial enteral nutrition in paediatric Crohn’s disease
Microbial composition and psychological wellbeing
Remission
Early remission of Crohn’s disease prevents progression
Proactive adalimumab trough measurements
Observational Studies
IBD risk of treatment with IL-17 antagonists
Basic and Preclinical Research
Immune cells and microbes: a happy marriage?
Genetics
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