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Anti-Integrin αvβ6 Autoantibodies Predict Response and Treatment Persistence to Advanced Therapies in Ulcerative
Shunsuke Shibui1,2, Kunio Asonuma1, Satoshi Kuronuma3
1Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
Introduction:
Anti-integrin αvβ6 (anti-αvβ6) autoantibodies serve as a diagnostic biomarker and are associated with poor prognosis in ulcerative colitis (UC). We aimed to investigate whether anti-αvβ6 autoantibody levels predict treatment outcomes of advanced therapies in patients with moderately to severely active UC.
Methods:
Anti-αvβ6 autoantibody levels were measured using prospectively collected serum samples at the initiation of advanced therapies. The primary outcome was treatment persistence up to 1 year; secondary outcomes included clinical remission rates at weeks 2, 6, 14, 24, and 48, comparing low-level and high-level groups stratified by an optimal cutoff from receiver operating characteristic analysis.
Results:
A total of 144 patients were analyzed (121 [84.0%] with extensive colitis and 87 [60.4%] with prior exposure to advanced therapies). The median observation period was 10 months, and treatment discontinuation occurred in 70 patients (48.6%). Treatment persistence was significantly higher in the low-level group (log-rank test, P = 0.002), and multivariable Cox analysis identified low antibody levels as the only independent predictor (hazard ratio, 1.90; 95% CI, 1.09-3.32). Clinical remission rates were consistently higher in the low-level group throughout all time points, with the greatest difference at week 6 (47.5% vs 20.0%; χ 2 test, P = 0.003). Low antibody levels remained an independent predictor of remission at all time points.
Discussion:
Anti-αvβ6 autoantibodies predicted both treatment persistence and clinical remission after advanced therapies, highlighting their potential as a predictive biomarker in patients with active UC.
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