UK Patients of Bangladeshi Descent with Crohn’s Disease Respond Less Well to TNF Antagonists Than Caucasian Patients

Gadhok, Radha; Gordon, Hannah; Sebepos‐Rogers, Gregory; Baillie, Samantha; Akbar, Saniath; Abbott, Jane; Michael, Emma; Ahmad, Omer F.; Cooper, Ben; Lindsay, James O.

doi:10.1007/s10620-019-05907-w

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…52 Others have shown that anti-TNF responses in Crohn's disease are determined by microbial status 21 which may explain recent findings of poor response to anti-TNF therapy in a South Asian sub-group. 53 In this study, we support previous findings of microbial differences in ethnic groups and describe new metabonomic findings in South Asians with ulcerative colitis. The majority of South Asians were second generation residents living in the same area as their Caucasian counterparts with similar diets on FFQs.…”

Section: Discussionsupporting

confidence: 91%

Ethnicity Associated Microbial and Metabonomic Profiling in Newly Diagnosed Ulcerative Colitis

Misra¹,

Sarafian²,

Pechlivanis³

et al. 2022

CEG

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Introduction:Ulcerative colitis (UC) differs across geography and ethnic groups. Gut microbial diversity plays a pivotal role in disease pathogenesis and differs across ethnic groups. The functional diversity in microbial-driven metabolites may have a pathophysiologic role and offer new therapeutic avenues. Methods: Demographics and clinical data were recorded from newly diagnosed UC patients. Blood, urine and faecal samples were collected at three time points over one year. Bacterial content was analysed by 16S rRNA sequencing. Bile acid profiles and polar molecules in three biofluids were measured using liquid-chromatography mass spectrometry (HILIC) and nuclear magnetic resonance spectroscopy. Results: We studied 42 patients with a new diagnosis of UC (27 South Asians; 15 Caucasians) with 261 biosamples. There were significant differences in relative abundance of bacteria at the phylum, genus and species level. Relative concentrations of urinary metabolites in South Asians were significantly lower for hippurate (positive correlation for Ruminococcus) and 4-cresol sulfate (Clostridia) (p<0.001) with higher concentrations of lactate (negative correlation for Bifidobacteriaceae). Faecal conjugated and primary conjugated bile acids concentrations were significantly higher in South Asians (p=0.02 and p=0.03 respectively). Results were unaffected by diet, phenotype, disease severity and ongoing therapy. Comparison of time points at diagnosis and at 1 year did not reveal changes in microbial and metabolic profile. Conclusion: Ethnic-related microbial metabolite associations were observed in South Asians with UC. This suggests a predisposition to UC may be influenced by environmental factors reflected in a distinct gene-environment interaction. The variations may serve as markers to identify risk factors for UC and modified to enhance therapeutic response.

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Section: Discussionsupporting

confidence: 91%

Ethnicity Associated Microbial and Metabonomic Profiling in Newly Diagnosed Ulcerative Colitis

Misra¹,

Sarafian²,

Pechlivanis³

et al. 2022

CEG

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Racial Difference in Efficacy of Golimumab in Ulcerative Colitis

Greywoode

Petralia

Ullman

et al. 2022

Inflammatory Bowel Diseases

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Background Observational studies have described racial differences in inflammatory bowel disease (IBD) genetics, clinical manifestations, and outcomes. Whether race impacts response to biologics in IBD is unclear. We conducted a post hoc analysis of phase 2 and 3 randomized clinical trials in ulcerative colitis to evaluate the effect of race on response to golimumab. Methods We analyzed pooled individual-level data from induction and maintenance trials of golimumab through the Yale Open Data Access Project. The primary outcome was clinical response. Secondary outcomes were clinical remission and endoscopic healing. Multivariable logistic regression was performed comparing White vs racial minority groups (Asian, Black, or other race), adjusting for potential confounders. Results There were 1006 participants in the induction (18% racial minority) and 783 participants in the maintenance (17% racial minority) trials. Compared with White participants, participants from racial minority groups had significantly lower clinical response (adjusted odds ratio [aOR], 0.43; 95% confidence interval [CI], 0.28-0.66), clinical remission (aOR, 0.41; 95% CI, 0.22-0.77), and endoscopic healing (aOR, 0.48; 95% CI, 0.31-0.74) at week 6. Participants from racial minority groups also had significantly lower clinical remission (aOR, 0.46; 95% CI, 0.28-0.74) and endoscopic healing (aOR, 0.63; 95% CI, 0.41-0.96) at week 30. There were no racial differences in placebo response rates. Conclusions Ulcerative colitis participants from racial minority groups were less likely to achieve clinical response, clinical remission, and endoscopic healing with golimumab compared with White participants in induction and maintenance trials. Further studies are needed to understand the impact of race on therapeutic response in IBD.

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UK Patients of Bangladeshi Descent with Crohn’s Disease Respond Less Well to TNF Antagonists Than Caucasian Patients

Cited by 2 publications

References 28 publications

Ethnicity Associated Microbial and Metabonomic Profiling in Newly Diagnosed Ulcerative Colitis

Ethnicity Associated Microbial and Metabonomic Profiling in Newly Diagnosed Ulcerative Colitis

Racial Difference in Efficacy of Golimumab in Ulcerative Colitis

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