Histological Predictors for Therapeutic Response to Integrin Inhibitors in Patients with Ulcerative Colitis.

Area of Science:

• Gastroenterology
• Histopathology
• Pharmacology

Background:

• Predicting treatment efficacy for advanced therapies in ulcerative colitis (UC) is critical.
• Few studies have identified predictive histological factors for UC treatment response.
• Conventional histology of pretreatment biopsy specimens may predict response to integrin inhibitors.

Purpose of the Study:

• To determine if conventional histology of pretreatment endoscopic biopsy specimens can predict response to integrin inhibitors in UC patients.
• To identify histological factors associated with primary response (PR) to integrin inhibitors.

Main Methods:

• Single-center retrospective study analyzing histopathological findings before integrin inhibitor initiation.
• Primary response (PR) defined as a ≥3-point decrease in partial Mayo score at 14 weeks.
• Logistic regression used to identify predictive factors for PR.

Main Results:

• 21 biological and Janus kinase inhibitor-naïve UC patients analyzed.
• Large lymphoid follicles (LF) present in 61.9% of patients.
• PR achieved in 57.1% of patients; 91.7% of responders had LF.
• LF presence significantly associated with response (76.9% vs. 12.5%, p=0.01).

Conclusions:

• Presence of large lymphoid follicles (LF) in biopsy specimens predicts response to integrin inhibitors in UC.
• Conventional histological examination can aid in predicting therapeutic responses to advanced therapies for UC.