P491 Efficacy and safety of upadacitinib for the treatment of fistulas and fissures in patients with Crohn’s disease

医学 瘘管 外科 克罗恩病 安慰剂 胃肠病学 临床试验 随机对照试验 内科学 疾病 病理 替代医学
作者
J F Colombel,Peter Irving,F Rieder,Remo Panaccione,David A. Schwartz,Reiko Hayashi,Xueqiong Zhu,Ana P. Lacerda,Elena Dubcenco,E Marced,P M Hecht,Ting Feng,Sjoerd A.A. van den Berg,Walter Reinisch
出处
期刊:Journal of Crohn's and Colitis [Oxford University Press]
卷期号:17 (Supplement_1): i620-i623 被引量:15
标识
DOI:10.1093/ecco-jcc/jjac190.0621
摘要

Abstract Background Intestinal and perianal fistulas and fissures are associated with significant morbidity and decreased quality of life in patients with Crohn’s disease (CD). We evaluated rates of fistula and fissure improvements with upadacitinib (UPA), an oral selective Janus kinase inhibitor, in patients with CD who had fistulas or fissures at baseline in phase 3 induction and maintenance trials. Methods In the U-EXCEL (NCT03345849) and U-EXCEED (NCT03345836) phase 3 induction trials, patients with moderate-to-severe CD were randomized to UPA 45 mg once daily (QD) or placebo (PBO) for 12 weeks. Patients who achieved clinical response after 12 weeks of induction were eligible for U-ENDURE (NCT03345823) and rerandomized to UPA 30 mg QD, UPA 15 mg QD, or PBO for an additional 52 weeks of maintenance treatment. Fistula activity was assessed by presence of external openings and draining upon gentle compression. Presence of perianal fissures was also assessed. The proportion of patients with external closure of fistula openings, complete resolution of draining, and ≥ 50% reduction in draining was recorded at weeks 12 and 52. Endpoints were analyzed using non-responder imputation. Results Of 1021 enrolled patients, 143 patients had fistulas (124 [86.7%] perianal; 19 [13.3%] enterocutaneous) and 54 patients had perianal fissures at baseline. The proportion of patients who achieved external closure of fistula openings was higher with UPA vs PBO at week 12 (Fig 1A) and at week 52 (Fig 2A). The proportion of patients who achieved complete resolution of draining and ≥ 50% reduction in draining was higher with UPA vs PBO at week 12 (Fig 1B and 1C) and at week 52 (Fig 2B and 2C). A higher proportion of patients achieved complete resolution of fissures with UPA vs PBO at week 12 (Fig 1D) and at week 52 (Fig 2D). At weeks 12 and 52, a higher proportion of patients with fistulas treated with UPA vs PBO achieved clinical remission and endoscopic response (Fig 1E and 2E). Rates of adverse events (AEs), serious AEs, or AEs leading to study drug discontinuation were similar in UPA groups compared with PBO during the induction and maintenance periods. Rates of abscess formation were 1.8% with UPA 45 mg and 6.8% with PBO at week 12, and 3.0% with UPA 30 mg, 6.4% with UPA 15 mg, and 2.5% with PBO at week 52. Conclusion Among patients with CD complicated with fistulas and/or fissures at baseline, UPA treatment led to higher rates of external closure of fistula openings, resolution of draining, and healing of fissures, along with clinical remission and improvements in luminal disease compared with PBO. No new safety concerns were identified.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
啾啾啾发布了新的文献求助10
1秒前
CHSLN完成签到 ,获得积分10
2秒前
biofresh发布了新的文献求助30
2秒前
2秒前
3秒前
超级无敌奥特大王完成签到,获得积分10
3秒前
NexusExplorer应助小包子采纳,获得10
3秒前
努力向前看完成签到,获得积分10
5秒前
5秒前
5秒前
agnes完成签到,获得积分10
6秒前
失眠的向日葵完成签到 ,获得积分10
6秒前
大橙子发布了新的文献求助10
7秒前
9秒前
10秒前
qq完成签到,获得积分10
11秒前
王二哈完成签到,获得积分10
12秒前
行者无疆发布了新的文献求助10
13秒前
令散内方完成签到,获得积分10
13秒前
外向的雁玉完成签到,获得积分10
13秒前
慧灰huihui发布了新的文献求助10
14秒前
Ava应助Desire采纳,获得10
15秒前
量子星尘发布了新的文献求助10
18秒前
风信子完成签到,获得积分10
18秒前
小熊完成签到 ,获得积分10
20秒前
24秒前
shu完成签到,获得积分10
24秒前
24秒前
勤奋的毛豆完成签到,获得积分10
27秒前
行者无疆完成签到,获得积分10
27秒前
28秒前
Jackylee完成签到,获得积分10
28秒前
careyzhou发布了新的文献求助10
29秒前
舒心之云完成签到,获得积分10
31秒前
Desire发布了新的文献求助10
31秒前
独自受罪完成签到 ,获得积分10
32秒前
甘蓝型油菜完成签到,获得积分10
33秒前
Distance发布了新的文献求助10
34秒前
大橙子发布了新的文献求助10
35秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038201
求助须知:如何正确求助?哪些是违规求助? 3575940
关于积分的说明 11373987
捐赠科研通 3305747
什么是DOI,文献DOI怎么找? 1819274
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022