Footnotes

• Twitter @QiSu_123, @Iris_R_Lau, @Siew_C_Ng

• QS and RIL contributed equally.

• Contributors QS and RIL conceptualised and designed the study. QS conducted data analyses. RIL collected and interpreted subjects' clinical data. QL provided critical suggestions on data analysis. FKLC contributed to the study design and data interpretation. SCN contributed to the study design, data analysis and manuscript writing. All authors gave final approval for the version to be published.

• Funding This work was supported by The Health and Medical Research Fund, the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region. The authors are partially supported by InnoHK, The Government of Hong Kong, Special Administrative Region of the People’s Republic of China. R.I.L. received additional support from the Hong Kong PhD Fellowship Scheme (HKPFS).

• Competing interests FKLC and SCN are the scientific co-founders and sit on the board of Directors of GenieBiome Ltd. SCN has served as an advisory board member for Pfizer, Ferring, Janssen, and Abbvie and a speaker for Ferring, Tillotts, Menarini, Janssen, Abbvie, and Takeda. She has received research grants from Olympus, Ferring, and Abbvie. FKLC has served as an advisor and lecture speaker for Eisai Co. Ltd., AstraZeneca, Pfizer Inc., Takeda Pharmaceutical Co., and Takeda (China) Holdings Co. Ltd. All other co-authors declare no competing interests.

• Provenance and peer review Not commissioned; externally peer reviewed.

• Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.