Early decline in anti-integrin αvβ6 autoantibodies strongly predicts 1-year clinical remission in vedolizumab-treated patients with ulcerative colitis

@article{roblin2026early,
  title = {{Early decline in anti-integrin αvβ6 autoantibodies strongly predicts 1-year clinical remission in vedolizumab-treated patients with ulcerative colitis}},
  author = {Xavier Roblin and Fatma Mechi and Anne-Emmanuelle Berger and Mathurin Fumery and Stéphane Nancey and Xavier Hébuterne and Franck Carbonnel and Romain Altwegg and Mathilde Barrau and Miles P Sparrow and Gerard Duru and Stephane Paul},
  journal = {eGastroenterology},
  year = {2026},
  month = nov,
  doi = {10.1136/egastro-2026-100598},
  url = {https://doi.org/10.1136/egastro-2026-100598},
  note = {CC BY-NC 4.0},
}

TY  - JOUR
TI  - Early decline in anti-integrin αvβ6 autoantibodies strongly predicts 1-year clinical remission in vedolizumab-treated patients with ulcerative colitis
AU  - Xavier Roblin
AU  - Fatma Mechi
AU  - Anne-Emmanuelle Berger
AU  - Mathurin Fumery
AU  - Stéphane Nancey
AU  - Xavier Hébuterne
AU  - Franck Carbonnel
AU  - Romain Altwegg
AU  - Mathilde Barrau
AU  - Miles P Sparrow
AU  - Gerard Duru
AU  - Stephane Paul
PY  - 2026
DA  - 2026/11/02
JO  - eGastroenterology
DO  - 10.1136/egastro-2026-100598
UR  - https://doi.org/10.1136/egastro-2026-100598
AB  - Background: Anti-integrin αvβ6 immunoglobulin G autoantibodies have emerged as one of the most accurate non-invasive biomarkers for ulcerative colitis (UC). We aimed to validate their diagnostic performance in a French multicentre cohort of patients with inflammatory bowel disease (IBD) and to evaluate their predictive value for vedolizumab clinical response.  Methods: We performed a multicentre, non-interventional post hoc analysis using prospectively collected serum samples and clinical data from two parent prospective observational studies: VEDOPREDIRESP (patients with IBD initiating vedolizumab) and GOLILOR (patients with UC undergoing golimumab dose intensification). Serum anti-αvβ6 autoantibody titres were quantified by ELISA at baseline and week 6 (VEDOPREDIRESP) or week 8 (GOLILOR), blinded to clinical outcomes. The primary endpoint was sustained clinical remission at week 52.  Results: In the VEDOPREDIRESP cohort (n=115; 67 UC, 48 Crohn’s disease (CD), sustained clinical remission at week 52 was achieved in 54% of patients with UC. Baseline serum anti-αvβ6 autoantibody titres were significantly higher in UC than in CD (median 271 ng/mL (IQR 38–884) vs 5.2 ng/mL (2.5–10), p<0.001), with seropositivity (>9.1 ng/mL) in 94% vs 19%, respectively. Receiver operating characteristic (ROC) analysis confirmed excellent diagnostic performance to discriminate between UC and CD (area under the ROC curve (AUC) 0.93; optimal cut-off 15 ng/mL; sensitivity 92%, specificity 95%). In patients with UC treated with vedolizumab, titres declined significantly from baseline to week 6 (median 243 ng/mL (176–884) to 190 ng/mL (89–320), p=0.040). A >30% reduction at week 6 strongly predicted sustained remission at week 52 (AUC 0.79; sensitivity 78%, specificity 80%). Multivariable analysis identified this early decline as the only statistically significant independent predictor of 1-year remission (adjusted OR 5.36, 95% CI 1.12 to 8.54, p=0.040). Notably, in an independent cohort of 47 patients with UC undergoing golimumab dose intensification, there was no reduction in median serum anti-αvβ6 autoantibody levels, with levels remaining stable from 197 ng/mL at week 0 to 205 ng/mL (97–457) at week 8 (p=0.730).  Conclusions: Anti-αvβ6 autoantibodies robustly discriminate UC from CD. In patients with UC treated with vedolizumab, their early and selective decline predicts clinical remission at 1 year and provides a precision tool to optimise gut-selective therapy in real time.
SN  - 2766-0125
SN  - 2976-7296
ER  -