Early MOnitoring of REsponse (MORE) to Golimumab Therapy: Results of a Multicentre, Prospective Observational Trial.


Journal

Digestive diseases (Basel, Switzerland)
ISSN: 1421-9875
Titre abrégé: Dig Dis
Pays: Switzerland
ID NLM: 8701186

Informations de publication

Date de publication:
2023
Historique:
received: 08 05 2022
accepted: 27 09 2022
pubmed: 3 11 2022
medline: 7 3 2023
entrez: 2 11 2022
Statut: ppublish

Résumé

The therapeutic goal of clinical remission in patients with moderate to severe ulcerative colitis (UC) is achieved after biological therapy only in 16-39%. Individualization of therapeutic intervention would benefit from prediction of early response. The primary objective of our study was to assess golimumab (GLM) trough serum level of ≥2.5 μg/mL in combination with a reduction of faecal calprotectin (FC) of ≥50% at week 6 compared to baseline to predict clinical response at week 26 after regular GLM intake. Patients with moderate to severe active UC and planned GLM treatment were recruited for a prospective, multicentre, observational study in Germany. Prediction of clinical response was assessed by FC and GLM trough level. Missing data were imputed as therapy failure according to the last observation carried forward method. Fifty nine patients have been enrolled. 54% of patients were anti-TNF naïve. Clinical response at week 6 was a significant predictor for achieving clinical response at week 26 (odds ratio [OR] 10.97, confidence interval [CI], 2.96-40.68; p < 0.001). Moreover, patients with a GLM trough level of ≥2.5 μg/mL and a ≥50% reduction of FC at week 6 had an OR of 5.33 (95% CI, 0.59-47.84) to achieve clinical response at week 26. Clinical response at week 6 is the best predictive marker for achieving clinical response at week 26. Consideration of significant reduction of FC and trough GLM serum levels could improve prediction of response.

Sections du résumé

BACKGROUND BACKGROUND
The therapeutic goal of clinical remission in patients with moderate to severe ulcerative colitis (UC) is achieved after biological therapy only in 16-39%. Individualization of therapeutic intervention would benefit from prediction of early response.
STUDY OBJECTIVE OBJECTIVE
The primary objective of our study was to assess golimumab (GLM) trough serum level of ≥2.5 μg/mL in combination with a reduction of faecal calprotectin (FC) of ≥50% at week 6 compared to baseline to predict clinical response at week 26 after regular GLM intake.
METHODS METHODS
Patients with moderate to severe active UC and planned GLM treatment were recruited for a prospective, multicentre, observational study in Germany. Prediction of clinical response was assessed by FC and GLM trough level. Missing data were imputed as therapy failure according to the last observation carried forward method.
RESULTS RESULTS
Fifty nine patients have been enrolled. 54% of patients were anti-TNF naïve. Clinical response at week 6 was a significant predictor for achieving clinical response at week 26 (odds ratio [OR] 10.97, confidence interval [CI], 2.96-40.68; p < 0.001). Moreover, patients with a GLM trough level of ≥2.5 μg/mL and a ≥50% reduction of FC at week 6 had an OR of 5.33 (95% CI, 0.59-47.84) to achieve clinical response at week 26.
CONCLUSION CONCLUSIONS
Clinical response at week 6 is the best predictive marker for achieving clinical response at week 26. Consideration of significant reduction of FC and trough GLM serum levels could improve prediction of response.

Identifiants

pubmed: 36323226
pii: 000527460
doi: 10.1159/000527460
doi:

Substances chimiques

golimumab 91X1KLU43E
Tumor Necrosis Factor Inhibitors 0

Types de publication

Observational Study Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

239-249

Informations de copyright

© 2022 S. Karger AG, Basel.

Auteurs

Ulf Helwig (U)

Internistische Praxengemeinschaft Oldenburg, Oldenburg, Germany.
Christian-Albrechts-Universität zu Kiel, UKSH Campus Kiel, Kiel, Germany.

Thomas Helmut Krause (TH)

Gastroenterologie Opernstraße, Kassel, Germany.

Christian Maaser (C)

Städtisches Klinikum Lüneburg, Lüneburg, Germany.

Jürgen Büning (J)

Praxis für Gastroenterologie, Lübeck, Germany.

Attyla Drabik (A)

Clinical Trial Support, Münster, Germany.

Margit Blömacher (M)

Kompetenznetz Darmerkrankungen, Kiel, Germany.

Sandra Plachta-Danielzik (S)

Kompetenznetz Darmerkrankungen, Kiel, Germany.

Niels Teich (N)

Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselerkrankungen, Leipzig, Germany.

Annette Krummenerl (A)

Krankenhaus Martha-Maria Halle-Dölau, Halle (Saale), Germany.

Andreas Sturm (A)

DRK Kliniken Berlin Westend, Berlin, Germany.

Matthias Schwab (M)

Institut für Klinische Pharmakologie, Stuttgart, Germany.
Department für Experimentelle und Klinische Pharmakologie und Pharmakogenomik, Universität Tübingen, Tübingen, Germany.

Stefan Schreiber (S)

Christian-Albrechts-Universität zu Kiel, UKSH Campus Kiel, Kiel, Germany.

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Classifications MeSH