Efficacy and Safety of Approximately 3 Years of Continuous Ozanimod in Moderately to Severely Active Ulcerative Colitis: Interim Analysis of the True North Open-label Extension.

Silvio Danese, AnnKatrin Petersen, Hsiuanlin Wu, Garrett Lawlor, Lorna Charles, Anjali Jain, Anita Afzali, Miguel Regueiro, David T Rubin, Douglas C Wolf, Michael V Chiorean, Maria T Abreu, Severine Vermeire, Subrata Ghosh, Jean-Frederic Colombel, Remo Panaccione, Axel Dignass, James B Canavan, Mark T Osterman

Journal: Journal of Crohn's & colitis 2024;18(2):264-274

PMID: 37651686

Abstract

BACKGROUNDS AND AIMS

This interim analysis from the True North open-label extension [OLE] study examines efficacy and safety of approximately 3 years of continuous ozanimod treatment in patients with moderately to severely active ulcerative colitis.

METHODS

Clinical responders after 52 weeks of ozanimod during the phase 3 True North study, who continued treatment in the OLE, were evaluated. Efficacy, including endoscopic and histological endpoints, was assessed during the OLE for approximately 2 additional years through OLE Week 94, using observed case [OC] and nonresponder imputation [NRI] analyses. Adverse events were monitored from True North baseline through OLE data cutoff and expressed as exposure-adjusted incidence rates.

RESULTS

This analysis included 131 patients; 54% had achieved corticosteroid-free remission at True North Week 52. In OC analyses, clinical response, clinical remission, and corticosteroid-free remission were achieved by 91.4%, 69.1%, and 67.9% of patients, respectively, at OLE Week 94 [146 weeks of total treatment]. Similarly, endoscopic improvement, histological remission, and mucosal healing were achieved by 73.3%, 67.3%, and 56.3% of patients, respectively, at OLE Week 94. Efficacy rates were lower using NRI analyses, but maintenance of efficacy was demonstrated through OLE Week 94. No new safety signals emerged from this analysis. Serious infections, malignancy, cardiovascular events, and hepatic events occurred infrequently.

CONCLUSIONS

Among patients who achieved clinical response after 1 year of ozanimod treatment during True North, a high percentage sustained clinical and mucosal efficacy over 2 additional years in the OLE. No new safety signals were observed with long-term ozanimod use.

© The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.

Address: Department of Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele, Milan, Italy.; Inflammatory Bowel Disease Unit, Gastrointestinal Research, Inflammatory Bowel Disease Clinic, Calgary, AB, Canada.; Crohn's & Colitis Center, University of Miami Miller School of Medicine, Miami, FL, USA.; Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Inflammatory Bowel Disease Center, Chicago, IL, USA.; University College Cork, Cork, Ireland.; Department of Medicine, Agaplesion Markus Hospital, Goethe University, Frankfurt, Germany.; University of Cincinnati College of Medicine, Cincinnati, OH, USA.; Internal Medicine and Gastroenterology, Atlanta Gastroenterology Associates LLC, Atlanta, GA, USA.; Inflammatory Bowel Disease Center, Swedish Gastroenterology, Issaquah, WA, USA.; Department of Chronic Diseases & Metabolism, University of Leuven, Leuven, Belgium.; Translational Sciences and Medical Affairs, Bristol Myers Squibb, Princeton, NJ, USA.; Worldwide Patient Safety, Bristol Myers Squibb, Princeton, NJ, USA.; GI Medicine, US Medical Affairs I&F, Bristol Myers Squibb, Princeton, NJ, USA.; Disease Area Head, Gastroenterology, Bristol Myers Squibb, Princeton, NJ, USA.; Statistician, Bristol Myers Squibb, Princeton, NJ, USA.; Bristol Myers Squibb, Princeton, NJ, USA.; Clinical Research at Celgene, Bristol Myers Squibb, Princeton, NJ, USA.; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
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