德卡伐替尼治疗炎症性肠病患者:来自3项克罗恩病和溃疡性结肠炎随机2期研究的12周疗效和安全性结果
Deucravacitinib in patients with inflammatory bowel disease: 12-week efficacy and safety results from 3 randomized phase 2 studies in Crohn's disease and ulcerative colitis.
作者信息
D'Haens Geert, Danese Silvio, Panaccione Remo, Rubin David T, Peyrin-Biroulet Laurent, Matsuoka Katsuyoshi, Loftus Edward V, Kobayashi Taku, Elsharkawi Walid, Miceli Rosa, Ahmed Samia, Luo Yi, Napoli Andrew, Vaile John, Dornic Quentin, Patel Aditya, Schreiber Stefan
机构信息
Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Department of Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy.
出版信息
J Crohns Colitis. 2025 Jun 4;19(6). doi: 10.1093/ecco-jcc/jjaf080.
BACKGROUND AND AIMS
Tyrosine kinase 2 is a downstream intracellular mediator of interleukin-23 signaling, which has a key role in the pathogenesis of inflammatory bowel disease. Deucravacitinib is a novel, oral, selective, allosteric tyrosine kinase 2 inhibitor currently approved for the treatment of adults with moderate to severe plaque psoriasis.
METHODS
Here we describe 3 randomized, double-blind, placebo-controlled phase 2 studies of deucravacitinib in patients with moderately to severely active Crohn's disease (LATTICE-CD [NCT03599622]) or ulcerative colitis (LATTICE-UC [NCT03934216] and IM011-127 [NCT04613518]). Patients were randomized to receive placebo or twice-daily deucravacitinib 3 or 6 mg (LATTICE-CD), 6 mg (LATTICE-UC), or 12 mg (IM011-127) for 12 weeks. Coprimary endpoints for LATTICE-CD were clinical remission and endoscopic response at week 12. The primary endpoint was clinical remission (per modified Mayo score) at week 12 for LATTICE-UC and clinical response (per modified Mayo score) at week 12 for IM011-127.
RESULTS
A total of 239 (LATTICE-CD), 131 (LATTICE-UC), and 38 (IM011-127) patients were randomized. The primary endpoints were not met for all 3 studies, which resulted in early study termination for LATTICE-CD and IM011-127. High efficacy rates were observed in placebo groups throughout the studies. In all studies, the safety profile of deucravacitinib was consistent with the known safety profile observed in patients with psoriasis, and no new safety signals were observed.
CONCLUSIONS
Deucravacitinib at multiple doses did not demonstrate significant clinical benefit vs placebo in moderately to severely active Crohn's disease or ulcerative colitis. Deucravacitinib was safe and well tolerated.
背景与目的
酪氨酸激酶2是白细胞介素-23信号传导的下游细胞内介质,在炎症性肠病的发病机制中起关键作用。德卡伐替尼是一种新型口服选择性变构酪氨酸激酶2抑制剂,目前已被批准用于治疗中度至重度斑块状银屑病成人患者。
方法
在此,我们描述了3项关于德卡伐替尼在中度至重度活动性克罗恩病(LATTICE-CD [NCT03599622])或溃疡性结肠炎(LATTICE-UC [NCT03934216]和IM011-127 [NCT04613518])患者中的随机、双盲、安慰剂对照2期研究。患者被随机分配接受安慰剂或每日两次3毫克或6毫克的德卡伐替尼(LATTICE-CD)、6毫克(LATTICE-UC)或12毫克(IM011-127),持续12周。LATTICE-CD的共同主要终点是第12周时的临床缓解和内镜反应。LATTICE-UC的主要终点是第12周时的临床缓解(根据改良梅奥评分),IM011-127的主要终点是第12周时的临床反应(根据改良梅奥评分)。
结果
共有239名(LATTICE-CD)、131名(LATTICE-UC)和38名(IM011-127)患者被随机分组。所有3项研究均未达到主要终点,导致LATTICE-CD和IM011-127提前终止研究。在整个研究过程中,安慰剂组观察到高有效率。在所有研究中,德卡伐替尼的安全性与银屑病患者中观察到的已知安全性一致,未观察到新的安全信号。
结论
在中度至重度活动性克罗恩病或溃疡性结肠炎中,与安慰剂相比,多剂量的德卡伐替尼未显示出显著的临床益处。德卡伐替尼安全且耐受性良好。