P2206 - Impact of Prior Biologic/Janus Kinase Inhibitor Therapy on the Efficacy of Etrasimod: Subgroup Analysis From the Phase 3 ELEVATE UC 52 and ELEVATE UC 12 Trials
Icahn School of Medicine at Mount Sinai New York, New York
Séverine Vermeire, MD, PhD1, Bruce E. Sands, MD, MS, FACG2, Laurent Peyrin-Biroulet, MD, PhD3, Geert D'Haens, MD, PhD4, Julian Panés, MD, PhD5, Andres J.. Yarur, MD6, Douglas C.. Wolf, MD7, Timothy E.. Ritter, MD8, Stefan Schreiber, MD9, Kevin Shan, PhD10, Christopher J.. Rabbat, PhD10, Michael V.. Chiorean, MD11, Filip Baert, MD12, Marla C. Dubinsky, MD13, Martina Goetsch, MD14, Silvio Danese, MD, PhD15, Brian G. Feagan, MD16 1UZ Leuven, Leuven, Vlaams-Brabant, Belgium; 2Icahn School of Medicine at Mount Sinai, New York, NY; 3Last Inserm U954 and CHU de Nancy, Lorraine University, Vandoeuvre-lès-Nancy, Lorraine, France; 4Amsterdam University Medical Center, Amsterdam, Noord-Holland, Netherlands; 5Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Catalonia, Spain; 6Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, CA; 7Atlanta Gastroenterology Associates, Atlanta, GA; 8GI Alliance, Southlake, TX; 9University Hospital Schleswig-Holstein, Kiel, Schleswig-Holstein, Germany; 10Pfizer Inc., New York, NY; 11Inflammatory Bowel Disease Center, Swedish Medical Center, Seattle, WA; 12AZ Delta, Roeselare, West-Vlaanderen, Belgium; 13Mount Sinai Kravis Children’s Hospital, New York, NY; 14Pfizer AG, Zurich, Zurich, Switzerland; 15IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Lombardia, Italy; 16Western University, London, ON, Canada
Introduction: Etrasimod is an investigational, oral, once-daily, selective sphingosine 1-phosphate (S1P)1,4,5 receptor modulator in development for the treatment of moderately to severely active ulcerative colitis (UC).
Methods: The study design for phase 3 ELEVATE UC 52 (NCT03945188) and ELEVATE UC 12 (NCT03996369) trials has been described previously.1 ELEVATE UC 52 comprised a 12-week (wk) induction period followed by a 40-wk maintenance period with a treat-through design. ELEVATE UC 12 comprised a 12-wk induction period. Patients (pts) had a documented history of inadequate response/loss of response/intolerance to ≥ 1 treatment for UC. This subgroup analysis evaluated the efficacy and safety of etrasimod 2 mg once daily vs placebo (PBO) in adults with UC by prior exposure to advanced (biologic/Janus kinase inhibitor [bio/JAKi]) therapy. We present subgroup efficacy analyses of the primary and select secondary endpoints at Wk 12 and Wk 52 in ELEVATE UC 52 and Wk 12 in ELEVATE UC 12 in pts naïve to, or with prior exposure to, ≥ 1 bio/JAKi therapy. Additional symptomatic endpoints were analyzed by study visit to Wk 12 (pooled ELEVATE UC 52 and ELEVATE UC 12).
Results: In ELEVATE UC 52 and ELEVATE UC 12, respectively, 274 and 222 pts with a baseline modified Mayo score 5–9 were treated with etrasimod, and 135 and 112 pts with PBO. Pts treated with etrasimod vs PBO, in both bio/JAKi-naïve and -exposed subgroups, achieved statistically significant improvements in clinical remission, clinical response and endoscopic improvement at Wks 12 and 52 in ELEVATE UC 52 (Table). In ELEVATE UC 12, bio/JAKi-naïve pts achieved statistically significant improvements in all endpoints, while pts in both subgroups achieved statistically significant improvements in clinical response (Table). In bio/JAKi-naïve and -exposed pts, respectively, pooled data showed the earliest significant improvements were during Wks 2 and 12 for symptomatic response and Wks 4 and 2 for symptomatic remission (Table).
Discussion: In ELEVATE UC 52, both bio/JAKi-naïve and -exposed pts treated with etrasimod showed statistically significant improvements in induction and maintenance efficacy endpoints vs PBO. In ELEVATE UC 12, etrasimod demonstrated statistically significant improvements vs PBO in induction in bio/JAKi-naïve pts. For symptomatic response in the pooled analysis, a significant treatment difference occurred later for bio/JAKi-exposed than -naïve pts.
Stefan Schreiber: AbbVie – Personal fees. Amgen – Personal fees. Arena Pharmaceuticals – Personal fees. Biogen – Personal fees. Bristol Myers Squibb – Personal fees. Celgene – Personal fees. Celltrion Healthcare – Personal fees. Dr. Falk Pharma – Personal fees. Eli Lilly – personal fees. Ferring Pharmaceuticals – personal fees. Fresenius Kabi – Personal fees. Galapagos – Personal fees. Gilead – Personal fees. Hikma Pharmaceuticals – Personal fees. I-Mab – Personal fees. Janssen Pharmaceuticals – Personal fees. Morphic – Personal fees. MSD – Personal fees. Mylan – Personal fees. Pfizer – Personal fees. Protagonist – Personal fees. ProventionBio – Personal fees. Sandoz/Hexal – personal fees. Takeda – Personal fees. Theravance Biopharma – Personal fees. UCB – personal fees.
Kevin Shan: Pfizer Inc – Employee, Stock-publicly held company(excluding mutual/index funds).
Christopher Rabbat: Pfizer Inc – Employee, Stock Options.
Séverine Vermeire, MD, PhD1, Bruce E. Sands, MD, MS, FACG2, Laurent Peyrin-Biroulet, MD, PhD3, Geert D'Haens, MD, PhD4, Julian Panés, MD, PhD5, Andres J.. Yarur, MD6, Douglas C.. Wolf, MD7, Timothy E.. Ritter, MD8, Stefan Schreiber, MD9, Kevin Shan, PhD10, Christopher J.. Rabbat, PhD10, Michael V.. Chiorean, MD11, Filip Baert, MD12, Marla C. Dubinsky, MD13, Martina Goetsch, MD14, Silvio Danese, MD, PhD15, Brian G. Feagan, MD16. P2206 - Impact of Prior Biologic/Janus Kinase Inhibitor Therapy on the Efficacy of Etrasimod: Subgroup Analysis From the Phase 3 ELEVATE UC 52 and ELEVATE UC 12 Trials, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.