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An ulcerative colitis taxonomy defined by individual patient-reported response trajectories.
Nature Medicine · · Journal Article · Open access
Schreiber, Yajnik + more
Abstract ↗AI summary
The abstract is read at the publisher; the summary is JClub's.
Four PRO-defined response-trajectory groups were identified in a phase 3b ulcerative colitis trial of 768 participants for vedolizumab and adalimumab.
- Why it matters: Precision medicine in UC is limited by not being able to predict and explain why patients respond differently to treatment.
- What they did: The study used PROs from a phase 3b trial (768 participants) to define trajectories, validated vedolizumab-linked trajectories in a second phase 3 trial (576 participants), and then used bulk, single-cell, spatial transcriptomics and proteomics to connect vedolizumab nonresponse to vascular inflammation involving SPP1+ macrophages and endothelial cells.
- The result: In real-world UC cohorts of 4,981 and 3,854 patients, renin-angiotensin system inhibitor use was associated with fewer long-term complications for vedolizumab but not anticytokine therapies, enabling a response-trajectory-based taxonomy that needs prospective validation.
The findingWhy it mattersWhat they didThe result
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