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在中度至重度活动溃疡性结肠炎中约 3 年连续奥扎那利单抗的疗效和安全性:真实北方开放标签扩展的中期分析。

Efficacy and Safety of Approximately 3 Years of Continuous Ozanimod in Moderately to Severely Active Ulcerative Colitis: Interim Analysis of the True North Open-label Extension.

机构信息

Department of Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milan, Italy.

Inflammatory Bowel Disease Unit, Gastrointestinal Research, Inflammatory Bowel Disease Clinic, Calgary, AB, Canada.

出版信息

J Crohns Colitis. 2024 Feb 26;18(2):264-274. doi: 10.1093/ecco-jcc/jjad146.

Abstract

BACKGROUNDS AND AIMS

This interim analysis from the True North open-label extension [OLE] study examines efficacy and safety of approximately 3 years of continuous ozanimod treatment in patients with moderately to severely active ulcerative colitis.

METHODS

Clinical responders after 52 weeks of ozanimod during the phase 3 True North study, who continued treatment in the OLE, were evaluated. Efficacy, including endoscopic and histological endpoints, was assessed during the OLE for approximately 2 additional years through OLE Week 94, using observed case [OC] and nonresponder imputation [NRI] analyses. Adverse events were monitored from True North baseline through OLE data cutoff and expressed as exposure-adjusted incidence rates.

RESULTS

This analysis included 131 patients; 54% had achieved corticosteroid-free remission at True North Week 52. In OC analyses, clinical response, clinical remission, and corticosteroid-free remission were achieved by 91.4%, 69.1%, and 67.9% of patients, respectively, at OLE Week 94 [146 weeks of total treatment]. Similarly, endoscopic improvement, histological remission, and mucosal healing were achieved by 73.3%, 67.3%, and 56.3% of patients, respectively, at OLE Week 94. Efficacy rates were lower using NRI analyses, but maintenance of efficacy was demonstrated through OLE Week 94. No new safety signals emerged from this analysis. Serious infections, malignancy, cardiovascular events, and hepatic events occurred infrequently.

CONCLUSIONS

Among patients who achieved clinical response after 1 year of ozanimod treatment during True North, a high percentage sustained clinical and mucosal efficacy over 2 additional years in the OLE. No new safety signals were observed with long-term ozanimod use.

摘要

背景和目的

本项来自真北(True North)开放性延伸(OLE)研究的中期分析,评估了奥扎莫德在中重度活动性溃疡性结肠炎患者中连续治疗约 3 年的疗效和安全性。

方法

在真北 3 期研究中,对第 52 周接受奥扎莫德治疗且临床应答的患者继续进行 OLE 治疗,对其进行评估。在 OLE 中通过 OC 分析和 NRI 分析评估大约 2 年的额外疗效终点,包括内镜和组织学终点。从真北研究基线至 OLE 数据截止期监测不良事件,并根据暴露调整发生率进行表述。

结果

本分析纳入 131 例患者;52 周时,54%的患者达到了无皮质激素缓解。在 OC 分析中,94 周(总治疗 146 周)时,分别有 91.4%、69.1%和 67.9%的患者达到临床应答、临床缓解和无皮质激素缓解。同样,73.3%、67.3%和 56.3%的患者分别达到内镜改善、组织学缓解和黏膜愈合。NRI 分析显示疗效较低,但至 OLE 94 周时疗效得以维持。本分析未发现新的安全性信号。严重感染、恶性肿瘤、心血管事件和肝脏事件发生率较低。

结论

在真北研究中,接受奥扎莫德治疗 1 年达到临床应答的患者中,在 OLE 中,有很大比例的患者在另外 2 年中维持了临床和黏膜疗效。长期使用奥扎莫德未观察到新的安全性信号。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7715/10896634/30368e2edb9b/jjad146_fig4.jpg

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