Baseline Serum and Stool Microbiome Biomarkers Predict Clinical Efficacy and Tissue Molecular Response After Ritlecitinib Induction Therapy in Ulcerative Colitis.

Autor:	Hassan-Zahraee M; Pfizer Inc, Cambridge, MA, USA., Ye Z; Pfizer Inc, Cambridge, MA, USA., Xi L; Pfizer Inc, Cambridge, MA, USA., Dushin E; Pfizer Inc, Cambridge, MA, USA., Lee J; Pfizer Inc, Cambridge, MA, USA., Romatowski J; Provincial Complex Hospital, Gastroenterology, Bialystok, Poland., Leszczyszyn J; Melita Medical, Gastroenterology, Wroclaw, Poland., Danese S; IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milan, Italy., Sandborn WJ; University of California San Diego, La Jolla, CA, USA., Banfield C; Pfizer Inc, Cambridge, MA, USA., Gale JD; Pfizer Inc, Cambridge, MA, USA., Peeva E; Pfizer Inc, Cambridge, MA, USA., Longman RS; Weill Cornell Medicine, Division of Gastroenterology and Hepatology, New York, NY, USA., Hyde CL; Pfizer Inc, Cambridge, MA, USA., Hung KE; Pfizer Inc, Cambridge, MA, USA.
Jazyk:	angličtina
Zdroj:	Journal of Crohn's & colitis [J Crohns Colitis] 2024 Sep 03; Vol. 18 (9), pp. 1361-1370.
DOI:	10.1093/ecco-jcc/jjad213
Abstrakt:	Background and Aims: Ritlecitinib, an oral JAK3/TEC family kinase inhibitor, was well-tolerated and efficacious in the phase 2b VIBRATO study in participants with moderate-to-severe ulcerative colitis [UC]. The aim of this study was to identify baseline serum and microbiome markers that predict subsequent clinical efficacy and to develop noninvasive serum signatures as potential real-time noninvasive surrogates of clinical efficacy after ritlecitinib. Methods: Tissue and peripheral blood proteomics, transcriptomics, and faecal metagenomics were performed on samples before and after 8 weeks of oral ritlecitinib induction therapy [20 mg, 70 mg, 200 mg, or placebo once daily, N = 39, 41, 33, and 18, respectively]. Linear mixed models were used to identify baseline and longitudinal protein markers associated with efficacy. The combined predictivity of these proteins was evaluated using a logistic model with permuted efficacy data. Differential expression of faecal metagenomics was used to differentiate responders and nonresponders. Results: Peripheral blood serum proteomics identified four baseline serum markers [LTA, CCL21, HLA-E, MEGF10] predictive of modified clinical remission [MR], endoscopic improvement [EI], histological remission [HR], and integrative score of tissue molecular improvement. In responders, 37 serum proteins significantly changed at Week 8 compared with baseline [false discovery rate of <0.05]; of these, changes in four [IL4R, TNFRSF4, SPINK4, and LAIR-1] predicted concurrent EI and HR responses. Faecal metagenomics analysis revealed baseline and treatment response signatures that correlated with EI, MR, and tissue molecular improvement. Conclusions: Blood and microbiome biomarkers stratify endoscopic, histological, and tissue molecular responses to ritlecitinib, which may help guide future precision medicine approaches to UC treatment. ClinicalTrials.gov NCT02958865. (© The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.)
Databáze:	MEDLINE
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