Hyams Jeffrey S, O'Brien Christopher D, Padgett Lakshmi, Rosh Joel R, Turner Dan, Veereman Genevieve, Griffiths Anne M, Heyman Melvin B, Wahbeh Ghassan, Adedokun Omoniyi J, Strauss Richard S, Lynch John P, Chan Daphne
Connecticut Children's Medical Center, Hartford, Connecticut, USA.
Janssen Research & Development, LLC, Spring House, Pennsylvania, USA.
Crohns Colitis 360. 2020 Aug 4;2(4):otaa063. doi: 10.1093/crocol/otaa063. eCollection 2020 Oct.
Long-term safety, pharmacokinetics, and efficacy of open-label golimumab therapy in children with moderate-severe ulcerative colitis were evaluated.
Week-6 golimumab responders (Mayo score decrease of ≥30% and ≥3 points from baseline, rectal bleeding subscore of 0/1 or ≥1 decrease from baseline) entered the long-term extension at week 14 and received maintenance therapy (subcutaneous, q4w). Patients ≥45 kg could receive at-home treatments at week 18. Pharmacokinetic, safety, and efficacy results were summarized through week 126 (2 years).
Among 35 enrolled children, 21 (60%) responded at week 6 and 20 entered the long-term extension (median age of 14.5 years and median weight of 46.1 kg). Eleven of 20 patients (55%) completed 2 years of treatment. No anaphylactic or serum sickness-like reactions, opportunistic infections, malignancies, tuberculosis, or deaths occurred. The safety profile of golimumab from weeks 14 through 126 and that observed through week 14 was generally consistent. Median trough golimumab concentrations in evaluable patients were consistent from weeks 14 (1.39, interquartile range 0.67-3.60) through 102 (1.18, 0.78-2.16), but higher at week 110 (4.10, 1.30-4.81). The incidence of antigolimumab antibodies increased from 10% (2/20) at week 30 to 25.0% (5/20) at week 126; 1 patient had neutralizing antibodies. At week 110, 50% (10/20) of patients were in remission (ie, Pediatric Ulcerative Colitis Activity Index <10). Among all enrolled patients, 28.6% (10/35) achieved remission at week 110.
Among children with ulcerative colitis who initially responded to golimumab induction and received q4w maintenance treatment in the long-term extension, 50% showed continued clinical benefit through 2 years. No new safety signals were observed.
评估了开放标签的戈利木单抗治疗中重度溃疡性结肠炎患儿的长期安全性、药代动力学及疗效。
第6周时戈利木单抗治疗有反应者(梅奥评分较基线降低≥30%且降低≥3分,直肠出血分项评分0/1或较基线降低≥1分)于第14周进入长期扩展期并接受维持治疗(皮下注射,每4周一次)。体重≥45 kg的患者在第18周可接受家庭治疗。总结了至第126周(2年)的药代动力学、安全性及疗效结果。
在35名入组儿童中,21名(60%)在第6周有反应,20名进入长期扩展期(中位年龄14.5岁,中位体重46.1 kg)。20名患者中有11名(55%)完成了2年治疗。未发生过敏或血清病样反应、机会性感染、恶性肿瘤、结核病或死亡。第14周至126周戈利木单抗的安全性概况与第14周观察到的情况总体一致。可评估患者中戈利木单抗的中位谷浓度在第14周(1.39,四分位间距0.67 - 3.60)至第102周(1.18,0.78 - 2.16)保持一致,但在第110周时较高(4.10,1.30 - 4.81)。抗戈利木单抗抗体的发生率从第30周时的10%(2/20)增至第126周时的25.0%(5/20);1名患者有中和抗体。在第110周时,50%(10/20)的患者处于缓解期(即儿童溃疡性结肠炎活动指数<10)。在所有入组患者中,28.6%(10/35)在第110周达到缓解。
在最初对戈利木单抗诱导治疗有反应并在长期扩展期接受每4周一次维持治疗的溃疡性结肠炎患儿中,50%在2年内持续显示出临床获益。未观察到新的安全信号。