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. 2023 Sep 5;6(3):pbad022.
doi: 10.1093/pcmedi/pbad022. eCollection 2023 Sep.

Trajectory of fecal lactoferrin for predicting prognosis in ulcerative colitis

Rirong Chen  1 , Li Li  1 , Yizhe Tie  1 , Minhu Chen  1 , Shenghong Zhang  1
Affiliations

Trajectory of fecal lactoferrin for predicting prognosis in ulcerative colitis

Rirong Chen et al. Precis Clin Med. .

Abstract

Objectives: To investigate the characteristics and prognostic value of fecal lactoferrin trajectories in ulcerative colitis (UC).

Methods: This study used data from the UNIFI trial (ClinicalTrials.gov, NCT02407236) and included patients who received ustekinumab during induction for trajectory modeling (n = 637). Patients who received ustekinumab during maintenance therapy were used for 1-year outcome analyses (n = 403). The levels of fecal lactoferrin, fecal calprotectin, and serum C-reactive protein were measured at weeks 0, 2, 4, and 8. The trajectories of these biomarkers were developed using a latent class growth mixed model.

Results: The trajectories of fecal lactoferrin, fecal calprotectin, and serum C-reactive protein were distinct, but all were associated with prior exposure to anti-tumor necrosis factor agents and vedolizumab. Furthermore, the fecal lactoferrin trajectory was the most valuable predictor of endoscopic, clinical, and histological remission. Compared to the high/moderate-rapid decrease trajectory group, the moderate-slow decrease, high-slow decrease, and high-stable groups had adjusted odds ratios (95% confidence interval) of 0.38 (0.18, 0.78; P = 0.010), 0.47 (0.23, 0.93; P = 0.032), and 0.33 (0.17, 0.63; P = 0.001), respectively, of 1-year endoscopic remission. Patients with high/moderate-rapid decrease trajectories also had the highest likelihood of achieving clinical and histological remission. Finally, we developed a patient-stratification scheme based on fecal lactoferrin trajectories and concentrations. Patients with good, moderate, and poor prognoses in the scheme had a distinct probability of achieving 1-year endoscopic remission (52.7%, 30.9%, and 12.8%, respectively).

Conclusions: The trajectory of fecal lactoferrin is a valuable prognostic factor for 1-year remission in UC.

Keywords: fecal lactoferrin; trajectory; ulcerative colitis.

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Conflict of interest statement

All authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Trajectory of inflammatory biomarkers: (A) fecal lactoferrin; (B) fecal calprotectin; and (C) C-reactive protein.
Figure 2.
Figure 2.
Scheme for patient stratification based on FL trajectory and week-8 FL level.
See this image and copyright information in PMC

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