Achievement of Endoscopic Remission After Induction Reduces Hospitalization Burden in Crohn's Disease: Findings From a Pooled Post Hoc Analysis of Risankizumab and Upadacitinib Phase III Trials

被引：0

作者：

Panaccione, Remo ^{[1
]}

Ma, Christopher ^{[1
,2
]}

Jairath, Vipul ^{[2
,3
,4
]}

Dignass, Axel ^{[5
]}

Joshi, Namita ^{[6
]}

Clark, Ryan ^{[6
]}

Griffith, Jenny ^{[6
]}

Kligys, Kristina ^{[6
]}

Semwal, Monika ^{[6
]}

Smith, Zachary ^{[7
]}

Mitchell, Dominic ^{[7
]}

Nunag, Dominic ^{[7
]}

Ferrante, Marc ^{[8
]}

机构：

[1] Univ Calgary, Div Gastroenterol & Hepatol, 2500 Univ Dr NW, Calgary, AB T2N 1N4, Canada

[2] Western Univ, Div Epidemiol & Biostat, London, ON, Canada

[3] Alimentiv Inc, London, ON, Canada

[4] Western Univ, Schulich Sch Med & Dent, Div Gastroenterol, London, ON, Canada

[5] Goethe Univ, Agaplesion Markus Hosp, Dept Med 1, Frankfurt, Germany

[6] AbbVie Inc, N Chicago, IL USA

[7] Medicus Econ LLC, Boston, MA USA

[8] Katholieke Univ Leuven, Univ Hosp Leuven, Dept Gastroenterol & Hepatol, Leuven, Belgium

来源：

JOURNAL OF CROHNS & COLITIS | 2024年 / 19卷 / 02期

关键词：

Endoscopy; Crohn's disease; hospitalization; mucosal healing; INFLAMMATORY-BOWEL-DISEASE; SCIENTIFIC WORKSHOP; OUTCOMES; PREDICTORS; GOALS; SCORE;

D O I：

10.1093/ecco-jcc/jjae128

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Endoscopic remission has emerged as an important treatment target in Crohn's disease (CD) and has been associated with improvement in long-term outcomes. We examined the relationship between achievement of endoscopic remission and hospitalizations using pooled data from 52-week Phase III maintenance trials of risankizumab and upadacitinib in patients with moderate-to-severe active CD.Methods Included patients received maintenance therapy after achieving a clinical response following a 12-week induction with risankizumab or upadacitinib. Endoscopic remission was defined as a Simple Endoscopic Score for Crohn's Disease (SES-CD) of no greater than 4, with at least a 2-point reduction vs induction baseline and no subscore greater than 1. All subsequent hospitalization events were recorded until completion of the maintenance trial or discontinuation. Exposure-adjusted negative binomial regression models were estimated to assess the relationship between post-induction endoscopic remission and long-term hospitalization, controlling for demographics, clinical variables, and treatment arm.Results Post-induction hospitalization rates were lower in patients who achieved endoscopic remission at the end of the induction period. In multivariable models, post-induction endoscopic remission was independently associated with incidence rate ratios of 0.45 (95% confidence interval [CI], 0.22-0.95, p = 0.036) and 0.71 (95% CI, 0.44-1.14, p = 0.156) for long-term disease-related and all-cause hospitalizations, respectively.Conclusions Week 12 endoscopic remission is independently associated with a reduction in 52-week disease-related hospitalizations. However, achieving this stringent endpoint within 12 weeks of therapy may be challenging. Endoscopic response may be a more realistic early endoscopic target in the post-induction timeframe. Additional research is needed to evaluate early achievement of alternative endoscopic endpoints in CD. Graphical Abstract

引用

页数：11

共 11 条

[11] Efficacy of vedolizumab during intravenous induction therapy in ulcerative colitis and Crohn's disease: post hoc analysis of patient-reported outcomes from the VISIBLE 1 and 2 studies
D'Haens, Geert
Baert, Filip
Danese, Silvio
Kobayashi, Taku
Loftus, Edward V.
Sandborn, William J.
Dornic, Quentin
Lindner, Dirk
Kisfalvi, Krisztina
Marins, Ed G.
Vermeire, Severine
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2024, 36 (04) : 404 - 415

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