Colon to Rectum
J Crohns Colitis. 2024;18(4):493–505
Baseline TREM-1 whole blood gene expression does not predict response to adalimumab treatment in patients with ulcerative colitis or Crohn’s disease in the SERENE studies
Background and aims: This study assessed whether baseline triggering receptor expressed on myeloid cells (TREM-1) whole blood gene expression predicts response to anti-tumour necrosis factor [anti-TNF] therapy in patients with ulcerative colitis [UC] or Crohn’s disease [CD].
Methods: TREM-1 whole blood gene expression was analysed by RNA sequencing in patients with moderately to severely active UC or CD treated with adalimumab in the Phase 3 SERENE-UC and SERENE-CD clinical trials. The predictive value of baseline TREM-1 expression was evaluated and compared according to endoscopic and clinical response versus non-response, and remission versus non-remission, at Weeks 8 and 52 (SERENE-UC), and Weeks 12 and 56 (SERENE-CD).
Results: TREM-1 expression was analysed in 95 and 106 patients with UC and CD, respectively, receiving standard-dose adalimumab induction treatment. In SERENE-UC, baseline TREM-1 expression was not predictive of endoscopic response (p = 0.48), endoscopic remission (p = 0.53), clinical response (p = 0.58), or clinical remission (p = 0.79) at Week 8, or clinical response (p = 0.60) at Week 52. However, an association was observed with endoscopic response (p = 0.01), endoscopic remission (p = 0.048), and clinical remission (p = 0.04997) at Week 52. For SERENE-CD, baseline TREM-1 expression was not predictive of endoscopic response (p = 0.56), endoscopic remission (p = 0.33), clinical response (p = 0.07), or clinical remission (p = 0.65) at Week 12, or endoscopic response (p = 0.61), endoscopic remission (p = 0.51), clinical response (p = 0.62), or clinical remission (p = 0.97) at Week 56.
Conclusions: Baseline TREM-1 gene expression did not uniformly predict adalimumab response in SERENE clinical trials. Further research is needed to identify potential blood-based biomarkers predictive of response to anti-tumour necrosis factor therapy in patients with inflammatory bowel disease.