UEG Journal Abstracts 2023 - 1032

PP0859
COMPARATIVE EFFICACY AND SAFETY OF BIOLOGIC THERAPIES IN
ELDERLY AND YOUNGER PATIENTS WITH INFLAMMATORY BOWEL
DISEASE
PP0860
THE ASSOCIATION OF ENDOSCOPIC AND HISTOLOGIC ENDPOINTS WITH
FAECAL CALPROTECTIN AND C-REACTIVE PROTEIN IN PATIENTS WITH
MODERATELY TO SEVERELY ACTIVE ULCERATIVE COLITIS TREATED WITH
MIRIKIZUMAB
K. Argyriou1, A. Manolakis1
E. Tsakiridou2
, S. Kyriakidis1
, C. Kateri1, T. Bektsis1
, A. Pappa1, A.N. Kapsoritakis1
1University of Thessaly Medical School and University Hospital of
Larissa, Department of Gastroenterology, Larissa, Greece, 2
School, University of Thessaly, Larissa, Greece
Medical
Contact E-Mail Address: kosnar2@yahoo.gr
Introduction: Biologic therapies are associated with an increased risk for
adverse events such as infections and malignancies. This is of particular
importance in elderly patients with inflammatory bowel disease (IBD).
Aims & Methods: The aim of this study was to compare the efficacy and
safety of different biologic therapies between IBD patients aged over 60
years and younger patients.All adult patients with IBD treated with biologic
agents from 2010 to 2022 in the sole tertiary referral center for inflammatory
bowel disease in central Greece were screened for eligibility
and their electronic medical records were retrospectively reviewed. Data
collected included the socio-demographic and clinical characteristics of
the study population, endoscopy reports as well as information regarding
treatment compliance and drug sustainability. Adverse events (AEs)
and serious AEs were also recorded. Patients with incomplete information
were excluded from the analysis.
Results: 267 IBD patients were screened for eligibility and 187 were included.
The majority (65%) of the patients had Crohn's disease. Of all
patients, 47.8% received infliximab, 18% adalimumab, 18% vedolizumab,
and 16% ustekinumab. The median duration of biologic treatments was
10 years. Parallel steroid therapy was required in 70% at baseline, 35% at
3 months, 18 % at 6 months, and 5% at 12 months from treatment onset.
The efficacy of biologic therapies did not differ significantly between patients
aged > 60 years and younger patients. Kaplan-Meyer analysis did
not show statistical differences or trends in drug sustainability (P > 0.05),
time to an adverse event (P >0.05), and infection rates (P >0.05) among
the different classes of biologic agents compared. The most common AEs
leading to drug discontinuation were loss of response and local injection
site reactions. After adjusting for differences in baseline characteristics between
the two age groups, no significant differences in drug sustainability
and the need for treatment optimization were found between elderly and
younger patients (p >0.05).
Conclusion: Available biologic therapies were characterized by comparable
efficacy, sustainability, and safety among elder and younger patients,
hardening the preferential selection among the available biologic agents
for the elderly. More real-world evidence is required to make treatment
recommendations.
References: 1. de Silva S, Devlin S, Panaccione R. Optimizing the safety of
biologic therapy for IBD. Nat Rev Gastroenterol Hepatol. 2010 Feb;7(2):93101.
doi: 10.1038/nrgastro.2009.221. PMID: 20134491.
2. Lasa JS, Olivera PA, Danese S, Peyrin-Biroulet L. Efficacy and safety of
biologics and small molecule drugs for patients with moderate-to-severe
ulcerative colitis: a systematic review and network meta-analysis. Lancet
Gastroenterol Hepatol. 2022 Feb;7(2):161-170. doi: 10.1016/S24681253(21)00377-0.
Epub 2021 Nov 29. PMID: 34856198.
Disclosure: Nothing to disclose.
,
R. Panaccione1, C. Sapin2, F. Chan-Diehl2
B. Siegmund3
, A. Walsh4
, T. Kobayashi5
, R. Moses2
, P. Dulai6
,
1University of Calgary, Medicine, Calgary, Canada, 2
Lilly and Company, Indianapolis, United States, 3Charité -
, S. Travis7
Eli
Universitätsmedizin Berlin, Med. Klinik m.S. Gastroenterologie,
Infektiologie und Rheumatologie, Berlin, Germany, 4
Hospital, Sydney, Australia, 5
St Vincent's
Kitasato University Kitasato Institute
Hospital, Minato-ku, Japan, 6University of California San Diego,
La Jolla, United States, 7John Radcliffe Hospital, Gastroenterology
Department, Oxford, United Kingdom
Contact E-Mail Address: britta.siegmund@charite.de
Introduction: Mirikizumab [(miri), a p19-directed IL-23 antibody] has been
shown to be effective in patients with moderately to severely active ulcerative
colitis (UC) in Phase 3, randomised, double-blind, placebo-controlled
trials (LUCENT-1 NCT03518086; LUCENT-2 NCT03524092).1
Given
the importance of understanding treat-to-target strategies, the relationship
between improved histologic and endoscopic endpoints and improvement
of the inflammatory biomarkers faecal calprotectin (fCal) and
C-reactive protein (CRP) was studied within miri-treated patients enrolled
in the programme.
Aims & Methods: This analysis focused on miri-treated patients (n=868)
from the induction study receiving intravenous (IV) every 4 weeks (Q4W)
until week (W)12 and miri induction responders at week W12, who were
rerandomised for the maintenance period, receiving subcutaneous miri
(n=365) Q4W up to W52. The relationship between achieving histologicendoscopic
mucosal improvement (HEMI), histologic-endoscopic mucosal
remission (HEMR) (definitions in Tables) and improvement of fCal
(≤250µg/g) and CRP (≤6mg/L) levels at W12 and W52 was explored using
Fisher's exact tests.
Relationship between mirikizumab treated patients
achieving HEMI and HEMR at end of induction (W12)
and normalised faecal calprotectin and C-reactive
protein values
Mirikizumab treated patients (N=868)
End of
inductionWeek
12
% fCal
≤ 250µg/g
% CRP
≤ 6mg/L
End of
inductionWeek
12
% fCal
≤ 250µg/g
% CRP
≤ 6mg/L
Patients
achieving
Patients not
achieving
HEMI (n=235) HEMI (n=633)
pvalue
179
(76.2%) 138 (21.8%) <0.001
208 (88.5%) 460 (72.7%) <0.001
Patients
achieving
HEMR
(n=193)
Patients not
achieving
HEMR
(n=675)
pvalue
153
(79.3%) 164 (24.3%) <0.001
173 (89.6%) 495 (73.3%) <0.001
Relationship between mirikizumab responder patients
rerandomised to mirikizumab achieving HEMI and
HEMR at end of maintenance (W52) and normalised
faecal calprotectin and C-reactive protein values
Mirikizumab induction responder patients
rerandomised to mirikizumab (n=365)
End of
maintenanceWeek
52
%
fCal≤250µg/g
%
CRP≤6mg/L
End of
maintenanceWeek
52
%
fCal≤250µg/g
%
CRP≤6mg/L
Patients
achieving
HEMI (n=174)
Patients not
achieving
HEMI
(n=191)
pvalue
129
(74.1%) 62 (32.5%) <0.001
153 (87.9%) 117 (61.3%) <0.001
Patients
achieving
HEMR
(n=158)
Patients not
achieving
HEMR
(n=207)
pvalue
121
(76.6%) 70 (33.8%) <0.001
139 (88.0%) 131 (63.3%) <0.001
Abbreviations: CRP=C-reactive protein; fCal=faecal calprotectin; HEMI=Histologic-endoscopic mucosal
improvement defined as Mayo Endoscopic Subscore (ES)=0 or 1 (excluding friability) and Geboes≤3.1; HEMR
Histologic-endoscopic mucosal remission defined as ES=0 or 1 (excluding friability) + Geboes≤2b; N=patient
population; n=patient subpopulation; W=week
Results: At W12, a significantly higher percentage of miri-treated patients
achieving HEMI (n=235/868) had normalised fCal and CRP values (76.2%
and 88.5%), compared to miri-treated patients who did not achieve HEMI
(n=633/868) (21.8% and 72.7%, both p<0.001; Table). Similarly, a higher
1032
UEG Journal | Abstract Book
IBD

UEG Journal Abstracts 2023

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UEG Journal Abstracts 2023 - 1160
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UEG Journal Abstracts 2023 - 1180
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