Higher vs Standard Adalimumab Induction and Maintenance Dosing Regimens for Treatment of Ulcerative Colitis: SERENE UC Trial Results.

Abstract

BACKGROUND & AIMS:

SERENE UC (Study of a Novel Approach to Induction and Maintenance Dosing With Adalimumab in Patients With Moderate to Severe Ulcerative Colitis) evaluated the efficacy of higher adalimumab induction and maintenance dose regimens in patients with ulcerative colitis.

METHODS:

This phase 3, double-blind, randomized trial included induction and maintenance studies, with a main study (ex-Japan) and Japan substudy. Eligible patients (18-75 years, full Mayo score 6-12, centrally read endoscopy subscore 2-3) were randomized 3:2 to higher induction regimen (adalimumab 160 mg at weeks 0, 1, 2, and 3) or standard induction regimen (160 mg at week 0 and 80 mg at week 2); all received 40 mg at weeks 4 and 6. At week 8, all patients were rerandomized 2:2:1 (main study) to 40 mg every week (ew), 40 mg every other week (eow), or exploratory therapeutic drug monitoring; or 1:1 (Japan substudy) to 40 mg ew or 40 mg eow maintenance regimens.

RESULTS:

In the main study, 13.3% vs 10.9% of patients receiving the higher induction regimen vs standard induction regimen achieved clinical remission (full Mayo score ≤2 with no subscore >1) at week 8 (induction primary end point; P = .265); among week-8 responders, 39.5% vs 29.0% receiving 40 mg ew vs 40 mg eow achieved clinical remission at week 52 (maintenance primary end point; P = .069). In the integrated (main + Japan) population, 41.1% vs 30.1% of week-8 responders receiving 40 mg ew vs 40 mg eow achieved clinical remission at week 52 (nominal P = .045). Safety profiles were comparable between dosing regimens.

CONCLUSION:

Although primary end points were not met, a >10% absolute difference in clinical remission was demonstrated with higher adalimumab maintenance dosing. Higher dosing regimens were generally well tolerated and consistent with the known safety profile of adalimumab in ulcerative colitis.

CLINICALTRIALS:

gov, Number: NCT002209456.

• Authors: Julián Panés, Jean-Frederic Colombel, Geert R D'Haens, Stefan Schreiber, Remo Panaccione, Laurent Peyrin-Biroulet, Edward V Loftus Jr, Silvio Danese, Satoshi Tanida, Yusuke Okuyama, Edouard Louis, Alessandro Armuzzi, Marc Ferrante, Harald Vogelsang, Toshifumi Hibi, Mamoru Watanabe, Jessica Lefebvre, Tricia Finney-Hayward, Yuri Sanchez Gonzalez, Thao T Doan, Nael M Mostafa, Kimitoshi Ikeda, Wangang Xie, Bidan Huang, Joel Petersson, Jasmina Kalabic, Anne M Robinson, William J Sandborn
• Journal: Gastroenterology (Gastroenterology) Vol. 162 Issue 7 Pg. 1891-1910 (06 2022) ISSN: 1528-0012 [Electronic] United States
• PMID: 35227777 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• Adalimumab

Topics

• Adalimumab (therapeutic use)
• Clinical Protocols
• Colitis, Ulcerative (chemically induced, diagnosis, drug therapy)
• Double-Blind Method
• Humans
• Remission Induction
• Treatment Outcome