P012 Ozanimod Reduced Fecal Calprotectin Levels in Patients with Ulcerative Colitis in the Phase 3 True North Study

Ghosh, Subrata; Geert, DʼHaens; Jairath, Vipul; Rieder, Florian; Petersen, AnnKatrin; Usiskin, Keith; Chitkara, Denesh K.; Jf, Colombel

doi:10.14309/01.ajg.0000722844.18503.37

Cited by 3 publications

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“…In randomized controlled clinical trials, ozanimod reduced the levels of the intestinal inflammatory markers fecal calprotectin (FCP) and fecal lactoferrin (FLF) during induction therapy in patients with UC; these reductions were maintained through maintenance therapy. [30] UC patients suffer from recurrent disease and their quality of life is significantly reduced. [31] For patients with severe disease activity, clinical trials have shown that corticosteroids are effective.…”

Section: Discussionmentioning

confidence: 99%

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Comparative of the effectiveness and safety of biological agents, small molecule drugs, and microbiome therapies in ulcerative colitis: Systematic review and network meta-analysis

Gao,

Nie,

Chen

et al. 2023

Medicine

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Background: Biological agents are commonly used for the first-line treatment of ulcerative colitis (UC). However, small-molecule drugs and microbiome therapies are now being used as new treatments for ulcerative colitis. We aimed to compare the relative efficacy and safety of biologics, small-molecule drugs, and microbiome therapies for the treatment of patients with moderate-to-severe ulcerative colitis. Methods: We searched the Cochrane, Embase, and PubMed databases from their inception to December 2022. RCTs that recruited patients with moderate-to-severe ulcerative colitis treated with biological agents, small-molecule drugs, and microbiome therapies. Efficacy outcomes were induction of clinical remission and mucosal healing; safety outcomes were adverse events and serious adverse events. A network meta-analysis with multivariate consistency model random-effect meta-regression was done, with rankings based on surface under the cumulative ranking curve (SUCRA) values. Higher SUCRA scores correlate with better efficacy, whereas lower SUCRA scores correlate with better safety. Results: A total of 31 RCTs comprising 7933 UC patients were included in our studies. A risk of bias assessment showed a low risk of bias for most of the included studies. Upadacitinib ranked highest for induction of clinical remission (SUCRA, 0.83) and mucosal healing (SUCRA, 0.44). Moreover, no treatments were found to increase the occurrence of adverse events compared with placebos. Ustekinumab ranked lowest for adverse events (SUCRA 0.26) and probiotic ranked lowest for serious adverse events (0·21), whereas tofacitinib ranked highest for adverse events (0·43) and upadacitinib ranked highest for serious adverse events (0·43). Conclusion: In this systematic review and network meta-analysis, we found upadacitinib to be ranked highest for the induction of clinical remission and mucosal healing, but the worst performing agent in terms of adverse events in UC patients. Probiotics were the best-performing agent for safety outcomes. More trials of direct comparisons are needed to inform clinical decision-making with greater confidence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%