Serum LRG useful biomarker of endoscopic activity in IBD patients on Humira
Serum Leucine-rich alpha-2 glycoprotein was a useful biomarker of endoscopic activity in patients with Crohn’s disease and ulcerative colitis taking Humira, according to a study published in Journal of Gastroenterology.
“[This] study shows that LRG, a novel serum biomarker, better reflects endoscopic activity during adalimumab (Humira; AbbVie) treatment than [c-reactive protein (CRP)] or [fecal calprotectin (fCal)] among [inflammatory bowel disease (IBD)] patients, indicating that LRG can be considered a potential biomarker to monitor disease activity during induction and maintenance therapy and can be incorporated in the treat-to-target strategy for the clinical management of IBD,” Shinichiro Shinzaki, MD, from the department of gastroenterology and hepatology, Osaka University Graduate School of Medicine, Yamadaoka, Japan, and colleagues wrote.
Shinzaki and colleagues identified 81 patients with moderate-to-severe IBD who received adalimumab therapy. At week 0, 12, 24 and 52, investigators measured serum LRG, CRP and fecal calprotectin levels. For UC, colonoscopy was performed at week 0, 12 and 52; and at 0, 24 and 52 weeks for CD. Researchers used the Simple Endoscopic Score for CD and Mayo endoscopic subscore for UC to assess endoscopic activity.
Results showed serum LRG levels decreased with adalimumab treatment (27.4 g/mL at week 0, 15.5 g/mL at week 12, 15.7 g/mL at week 24, and 14.5 g/mL at week 52). In addition, investigators noted improvements in clinical and endoscopic outcomes.
The researchers report that the decrease in serum LRG levels correlated with endoscopy activity at each time point (SES-CD: r=0.391 at week 0, r=0.563 at week 24, r=0.697 at week 52; MES: r=0.534 at week 0, r=0.429 at week 12, r=0.335 at week 52).
Moreover, endoscopic activity was better correlated with LRG vs. CRP and fCal on pooled analysis at all time points (SES-CD: LRG: r=0.636, CRP: r=0.402, fCal: r=0.435; MES: LRG: r=0.568, CRP: 0.389, fCal: r=0.426).
“The present results support the use of LRG during induction therapy for IBD as follows: LRG levels can be determined before treatment initiation for induction of remission and then measured periodically to monitor changes in disease activity,” Shinzaki and colleagues wrote. “If LRG levels do not decrease, treatment should be intensified. If LRG levels are within normal levels, colonoscopy should be performed to confirm mucosal healing, which is currently the most reliable therapeutic goal, and maintenance therapy can be continued.”