P3603 - Efficacy and Safety of Etrasimod in Patients With Moderate to Severe Isolated Proctitis Relative to Those With More Extensive Colitis: Results From the Phase 3 ELEVATE UC 52 and ELEVATE UC 12 Trials
Mount Sinai Kravis Children’s Hospital New York, NY
Laurent Peyrin-Biroulet, MD, PhD1, Marla C. Dubinsky, MD2, Bruce E. Sands, MD, MS, FACG3, Julian Panés, MD, PhD4, Stefan Schreiber, MD5, Walter Reinisch, MD6, Brian G. Feagan, MD7, Silvio Danese, MD, PhD8, Andres J.. Yarur, MD9, Geert D'Haens, MD, PhD10, Martina Goetsch, MD11, Karolina Wosik, MSc, PhD12, Joseph Wu, PhD13, Irene Modesto, MD, PhD14, Aoibhinn McDonnell, PhD15, Lauren Bartolome, PharmD, MS14, Christopher J.. Rabbat, PhD14, Séverine Vermeire, MD, PhD16 1Last Inserm U954 and CHU de Nancy, Lorraine University, Vandoeuvre-lès-Nancy, Lorraine, France; 2Mount Sinai Kravis Children’s Hospital, New York, NY; 3Icahn School of Medicine at Mount Sinai, New York, NY; 4Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Catalonia, Spain; 5University Hospital Schleswig-Holstein, Kiel, Schleswig-Holstein, Germany; 6Medical University of Vienna, Vienna, Wien, Austria; 7Western University, London, ON, Canada; 8IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Lombardia, Italy; 9Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, CA; 10Amsterdam University Medical Center, Amsterdam, Noord-Holland, Netherlands; 11Pfizer AG, Zurich, Zurich, Switzerland; 12Pfizer Canada, Kirkland, PQ, Canada; 13Pfizer Inc., Cambridge, MA; 14Pfizer Inc., New York, NY; 15Pfizer Ltd., Sandwich, England, United Kingdom; 16UZ Leuven, Leuven, Vlaams-Brabant, Belgium
Introduction: Most clinical trials of systemic ulcerative colitis (UC) therapies exclude patients (pts) with isolated proctitis, who are considered a more treatment-refractory population, creating a need for clinical evidence. 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 UC. The phase 3 etrasimod ELEVATE UC trials included pts with isolated proctitis (< 10 cm rectal involvement), provided they met all other eligibility criteria.1
Methods: This post hoc analysis assessed predefined efficacy and safety outcomes in subgroups of pts with isolated proctitis and more extensive colitis (proctosigmoiditis/left-sided colitis/pancolitis). In ELEVATE UC 52 (NCT03945188) and ELEVATE UC 12 (NCT03996369), pts (aged 16–80 years) with moderately to severely active UC were randomized 2:1 to etrasimod 2 mg once daily or placebo. 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. Clinical endpoints were assessed in pts with isolated proctitis (data pooled from both trials) and in pts with more extensive colitis (individual trial data). Sustained and corticosteroid-free clinical remission were assessed at Wk 52 (ELEVATE UC 52 only). Bowel urgency Numeric Rating Scale (NRS) was assessed at Wks 12 and 52. Safety was assessed up to Wk 52.
Results: This analysis included 64 (pooled; Wk 12) and 36 (ELEVATE UC 52; Wk 52) pts with isolated proctitis, and 397 (ELEVATE UC 52; Wks 12 and 52) and 326 (ELEVATE UC 12; Wk 12) pts with more extensive colitis. Similar proportions of pts with isolated proctitis achieved the predefined efficacy endpoints vs those with more extensive colitis (Table). Pts with isolated proctitis receiving etrasimod had similar improvements in urgency NRS scores vs those with more extensive colitis (mean change from baseline: Wk 12, -2.8 vs -2.9 [both trials]; Wk 52, -5.0 vs -4.1). Safety in pts with isolated proctitis was generally similar to that in the overall trial population.1
Discussion: Etrasimod treatment had similar efficacy in pts with isolated proctitis and in those with more extensive colitis. Prospective confirmation in larger pt cohorts with isolated proctitis is necessary. Safety was consistent with the overall population.1
Reference 1. Sandborn WJ et al. Lancet 2023; 401: 1159-1171
Bruce Sands: AbbVie – Consultant. Abivax – Consultant, Speaker’s fees. Adiso Therapeutics – Consultant. Alimentiv – Consultant. Amgen – Consultant. Arena pharmaceuticals – Consultant. Artizan Biosciences – Consultant. Artugen Therapeutics – Consultant. AstraZeneca – Consultant. Bacainn Therapeutics – Consultant. Biora Therapeutics – Consultant. Boehringer Ingelheim – Consultant. Boston Pharmaceuticals – Consultant. Bristol Myers Squibb – Consultant, Grant/Research Support, speaking fees and other support. Calibr – Consultant. Celltrion – Consultant. ClostraBio – Consultant. Connect Biopharm – Consultant. Cytoki Pharma – Consultant. Eli Lilly – Consultant, speaking fees and other support. Enthera – Consultant. Evommune – Consultant. Ferring – Consultant. Fresenius Kabi – Consultant. Galapagos – Consultant. Genentech – Consultant. Gilead Sciences – Consultant. GlaxoSmithKline – Consultant. Gossamer Bio – Consultant. HMP Acquisition – Consultant. Imhotex – Consultant. Immunic – Consultant. InDex Pharmaceuticals – Consultant. Innovation Therapeutics – Consultant. Inotrem – Consultant. Ironwood Pharmaceuticals – Consultant. Janssen – Grant/Research Support, consulting and speaking fees and other support. Johnson & Johnson – Consultant. Kaleido Biosciences – Consultant. Kallyope – Consultant. Merck – Consultant. MiroBio – Consultant. Morphic Therapeutics – Consultant. MRM Health – Consultant. OSE Immunotherapeutics – Consultant. Pfizer Inc – Consultant, Grant/Research Support, speaking fees and other support. Progenity – Consultant. Prometheus Biosciences – Consultant. Prometheus Laboratories – Consultant. Protagonist Therapeutics – Consultant. Q32 Bio – Consultant. RedHill Biopharma – Consultant. Sun Pharma – Consultant. Surrozen – Consultant. Synlogic Operating Company – Consultant. Takeda – Grant/Research Support, consulting and speaking fees and other support. Target RWE – Consultant. Theravance Biopharma – Consultant, Grant/Research Support. TLL Pharmaceutical – Consultant. USWM Enterprises – Consultant. Ventyx Biosciences – Consultant, personal fees and stock options for consulting. Viela Bio – Consultant.
Julian Panés: AbbVie – Grant/Research Support, Personal fees. Arena – Consultant. Athos – Consultant. Atomwise – Consultant. Boehringer Ingelheim – Consultant. Celgene – Consultant. Celltrion – Consultant. Ferring – Consultant, Speakers Bureau. Galapagos – Consultant. Genentech/Roche – Consultant. GlaxoSmithKline – Consultant. Immunic – Personal fees. Janssen – Consultant, payment for development of educational presentations. Mirum – Consultant. Morphic – Consultant. Origo – Consultant. Pandion – Consultant. Pfizer Inc – Grant/Research Support, payment for development of educational presentations. Progenity – Consultant. Revolo – Consultant. Takeda – payment for development of educational presentations. Theravance – Consultant. Wasserman – Consultant.
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.
Laurent Peyrin-Biroulet, MD, PhD1, Marla C. Dubinsky, MD2, Bruce E. Sands, MD, MS, FACG3, Julian Panés, MD, PhD4, Stefan Schreiber, MD5, Walter Reinisch, MD6, Brian G. Feagan, MD7, Silvio Danese, MD, PhD8, Andres J.. Yarur, MD9, Geert D'Haens, MD, PhD10, Martina Goetsch, MD11, Karolina Wosik, MSc, PhD12, Joseph Wu, PhD13, Irene Modesto, MD, PhD14, Aoibhinn McDonnell, PhD15, Lauren Bartolome, PharmD, MS14, Christopher J.. Rabbat, PhD14, Séverine Vermeire, MD, PhD16. P3603 - Efficacy and Safety of Etrasimod in Patients With Moderate to Severe Isolated Proctitis Relative to Those With More Extensive Colitis: Results 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.