Chen Baili, Ye Byong Duk, Cao Qian, Hirai Fumihito, Saruta Masayuki, Chen Minhu, Pelak Susan, Shipitofsky Nicole, Miao Ye, Herr Keira, Wahking Bryan, Zhuo Jianmin, Hisamatsu Tadakazu
The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
J Gastroenterol Hepatol. 2025 Sep;40(9):2197-2208. doi: 10.1111/jgh.17036. Epub 2025 Jun 26.
The global QUASAR (NCT04033445) clinical program demonstrated the efficacy and safety of guselkumab, a dual-acting interleukin-23 p19 subunit inhibitor, as induction and maintenance therapy in participants with moderate to severely active ulcerative colitis (UC). We report a subgroup analysis in East Asian participants.
The QUASAR program included two randomized, placebo-controlled, 12-week induction studies of guselkumab 200 mg (and 400 mg, Phase 2b) IV every 4 weeks (q4w) in adults with baseline modified Mayo scores of 5-9 and inadequate response/intolerance to conventional and/or advanced UC therapy. Clinical responders to guselkumab induction were re-randomized (1:1:1) at maintenance study baseline to SC guselkumab 200 mg q4w, 100 mg q8w, or placebo. Primary endpoints were clinical response (Phase 2b) or clinical remission (Phase 3) at induction Week 12 (I-12) and clinical remission at maintenance Week 44 (M-44). Subgroup analyses included participants from sites in China, Japan, Korea, and Taiwan region.
Data were from 71 (Phase 2b) and 135 (Phase 3) East Asians in the induction studies and 106 in the maintenance study. At Week I-12, 45.5%-58.8% of guselkumab versus 25.5%-29.2% of placebo participants achieved clinical response and 16.0%-23.8% versus 4.2%-5.5%, respectively, achieved clinical remission. At Week M-44, 37.1%-46.3% of guselkumab versus 13.3% of placebo participants achieved clinical remission. The adverse event profile was generally consistent with the global QUASAR population.
Results support the efficacy and safety of guselkumab induction and maintenance in East Asians with moderately to severely active UC, consistent with findings from the global QUASAR studies.
ClinicalTrials.gov, NCT04033445; EudraCT, 2018-004002-25.
全球QUASAR(NCT04033445)临床项目证明了古塞库单抗(一种双效白细胞介素-23 p19亚基抑制剂)作为中度至重度活动性溃疡性结肠炎(UC)患者诱导和维持治疗的有效性和安全性。我们报告了对东亚参与者的亚组分析。
QUASAR项目包括两项随机、安慰剂对照的12周诱导研究,研究对象为基线改良梅奥评分5 - 9分且对传统和/或先进UC治疗反应不足/不耐受的成年人,每4周静脉注射200mg(2b期为400mg)古塞库单抗。对古塞库单抗诱导有临床反应的患者在维持研究基线时重新随机分组(1:1:1),分别接受每4周皮下注射200mg古塞库单抗、每8周皮下注射100mg古塞库单抗或安慰剂。主要终点为诱导期第12周(I - 12)的临床反应(2b期)或临床缓解(3期)以及维持期第44周(M - 44)的临床缓解。亚组分析包括来自中国、日本、韩国和台湾地区研究点的参与者。
诱导研究中有71名(2b期)和135名(3期)东亚参与者以及维持研究中的106名东亚参与者的数据纳入分析。在I - 12周时,接受古塞库单抗治疗的参与者中45.5% - 58.8%达到临床反应,而接受安慰剂治疗的参与者中这一比例为25.5% - 29.2%;达到临床缓解的比例分别为16.0% - 23.8%和4.2% - 5.5%。在M - 44周时,接受古塞库单抗治疗的参与者中37.1% - 46.3%达到临床缓解,而接受安慰剂治疗的参与者中这一比例为13.3%。不良事件情况与全球QUASAR人群总体一致。
结果支持古塞库单抗在中度至重度活动性UC东亚患者中诱导和维持治疗的有效性和安全性,与全球QUASAR研究结果一致。
ClinicalTrials.gov,NCT04033445;EudraCT,2018 - 004002 - 25。