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Anti-MAdCAM-1 antibody (PF-00547659) for active refractory Crohn’s disease in Japanese and Korean patients: the OPERA study

Intestinal Research 2020년 18권 1호 p.45 ~ 55
 ( Saruta Masayuki ) - Jikei University School of Medicine Department of Internal Medicine

박동일 ( Park Dong-Il ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Internal Medicine
김영호 ( Kim Young-Ho ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
양석균 ( Yang Suk-Kyun ) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
장병익 ( Jang Byung-Ik ) - Yeungnam University College of Medicine Department of Internal Medicine
천재희 ( Cheon Jae-Hee ) - Yonsei University College of Medicine Department of Internal Medicine
임종필 ( Im Jong-Pil ) - Seoul National University Hospital Department of Internal Medicine
 ( Kanai Takanori ) - Keio University Hospital Department of Internal Medicine
 ( Katsuno Tatsuro ) - Chiba University Hospital Department of Gastroenterology
 ( Ishiguro Yoh ) - Hirosaki National Hospital Department of Gastroenterology and Hematology

Abstract


Background/Aims: PF-00547659 is a monoclonal antibody against human mucosal addressin cell adhesion molecule-1 (MAdCAM-1) that prevents the binding of α4β7+ lymphocytes to MAdCAM-expressing sites in the gastrointestinal tract with high affinity and selectivity, and is being developed for the treatment of Crohn’s disease (CD).

Methods: OPERA is a randomized, multicenter, double-blind, placebo-controlled study to investigate the efficacy, safety, and pharmacokinetics of PF-00547659 following subcutaneous administration in subjects with active CD, a history of failure or intolerance to anti-tumor necrosis factor and/or immunosuppressants, high-sensitivity C-reactive protein > 3.0 mg/L, and ulcers on colonoscopy. The primary endpoint was Crohn’s Disease Activity Index-70 response at week 8 or 12. Subpopulation analyses for Asian subjects were performed as some differences are observed in genetics and clinical phenotypes in Asian CD patients compared with Western patients.

Results: In this study, 265 CD subjects were randomized, with a subpopulation of 21 subjects (8 Japanese and 13 Korean) defined as the Asian population. In the overall and Asian populations; PF-00547659 was pharmacologically active as evidenced by soluble MAdCAM and circulating β7+ central memory CD4+ T-lymphocytes, although no clear evidence of efficacy was observed in any clinical endpoints; pharmacokinetics of PF-00547659 in the Asian subpopulation was generally comparable to the overall population; and the safety profile of PF-00547659 appeared acceptable up to 12 weeks of treatment.

Conclusions: In the overall and Asian populations, efficacy of PF-00547659 could not be demonstrated using any clinical endpoints compared with placebo. Pharmacokinetics and safety of PF-00547659 were generally comparable. Further studies with larger numbers of patients are required to confirm our results. (Trial Registration Number: NCT01276509)

키워드

PF-00547659; MAdCAM; Crohn disease; Japanese; Korean
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