S754 Impact of Mirikizumab Treatment on Health-Related Quality of Life in Patients With Crohn’s Disease: A Phase 2 Study Analysis Using the SF-36
Notice bibliographique
Résumé
Introduction: This analysis evaluated Mirikizumab (miri) effects on Short Form Health Survey (SF-36) in the Phase (Ph)2 randomised, double-blind, parallel, placebo (PBO)-controlled study in patients (pts) with moderately-to-severely active Crohn’s disease (CD). Methods: 12-Week(W) Induction: 191 pts were randomized 2:1:1:2 to 4 treatment arms: intravenous (IV) PBO, 200, 600, or 1000mg miri every 4 weeks (Q4W; W0, 4, and 8). 40-W Maintenance: For miri induction dose, pts achieving ≥1-point improvement in Simple Endoscopic Score for CD (SES-CD) at W12 were re-randomized 1:1 to double-blind maintenance treatment from W12 to W48: continuation of induction IV treatment assignment (IV-IV; N=41) or subcutaneous (SC) 300mg miri Q4W (IV-SC; N=46). Due to small sample sizes, maintenance IV arms and SC arms were pooled. W12 SES-CD non-improvers (N=30) and pts receiving PBO during induction (N=59) received IV 1000mg miri Q4W from W12 to W48. No statistical comparisons were made between miri treatment groups in the maintenance period. SF-36 was assessed at baseline and at W4,12,16, 24, 32, 44, and 52. Results: Statistically significant improvement in MCS was observed at W4 (600mg dose level) and at W12 (all dose levels), whereas statistically significant improvements in PCS were observed only at W12 (600 and 1000mg dose levels) compared to PBO (Table). Though statistical comparisons were not made between treatment groups during maintenance, comparison of mean changes in MCS and PCS suggest that improvements during induction were sustained or further numerically increased with miri maintenance treatment, even in induction SES-CD non-improvers (Table). Conclusion: These data show that miri treatment improves health related quality of life in pts with moderately to severely active CD and suggest an earlier impact on mental compared to physical wellbeing. Maintenance treatment effects were numerically consistent or increased compared to induction effects, even among more refractory pts. These findings will be validated in the ongoing miri Ph3 CD study (NCT03926130). Proinflammatory signals can induce anxiety and depressive symptoms; better understanding of how the effects of anti-inflammatory treatment on the gut-brain axis may improve mental and physical subjective wellbeing requires additional mechanistic studies. Table 1. - Effect of mirikizumab on SF-36 MCS and PCS Change from Baseline Mental Component Score (MCS) Physical Component Score (PCS) Induction Period PBO (N=64) 200 mg IV miri (N=31) 600 mg IV miri (N=32) 1000 mg IV miri (N=64) PBO (N=64) 200 mg IV miri (N=31) 600 mg IV miri (N=32) 1000 mg IV miri (N=64) W0 Baseline (Mean ± SD) 37.0 ± 13.2 35.2 ± 10.2 41.1 ± 10.4 40.4 ± 11.6 38.9 ± 8.3 38.4 ± 6.4 42.9 ± 7.8 39.5 ± 8.6 W4 CFBL (LSM ± SE) 1.9 ± 1.0 2.6 ± 1.4 5.2 ± 1.4* 3.1 ± 1.0 2.4 ± 0.7 3.3 ± 1.0 3.4 ± 1.0 4.2 ± 0.7 W12 CFBL (LSM ± SE) 2.3 ± 1.1 7.5 ± 1.6* 6.5 ± 1.6* 6.1 ± 1.2* 3.1 ± 0.8 4.7 ± 1.1 8.0 ± 1.1** 6.7 ± 0.8** Maintenance Period PBO-1000 mg IV miri (N=59) NI-1000 mg IV miri (N=30) All IV-IV miri (N=41) All IV-SC miri (N=46) PBO-1000 mg IV miri (N=59) NI-1000 mg IV miri (N=30) All IV-IV miri (N=41) All IV-SC miri (N=46) W0 Baseline (Mean ± SD) 37.2 ±13.0 38.0 ±11.2 42.0 ± 10.1 38.7 ±10.7 39.5 ± 8.1 40.8 ± 8.3 41.1 ± 8.5 38.1 ± 7.1 W24 CFBL (Mean ± SD) 7.4 ± 8.7 7.7 ± 11.7 7.0 ± 10.6 5.9 ± 13.1 6.8 ± 7.3 7.1 ± 7.8 9.6 ± 5.6 7.1 ± 8.3 W52 CFBL (Mean ± SD) 7.1 ± 10.6 7.3 ± 9.8 8.5 ± 11.3 11.5 ± 11.4 9.9 ± 7.2 7.1 ± 8.2 10.2 ± 8.7 10.7 ± 7.9 Abbreviations: CFBL = change from baseline; IV = intravenous; IV-IV = pooled maintenance IV treatment arms for patients at each miri induction dose level who achieved ≥1-point improvement in SES-CD at W12 who were re-randomized to continued induction IV treatment assignment during maintenance; IV-SC = pooled maintenance SC treatment arms for patients at each miri induction dose level who achieved ≥1-point improvement in SES-CD at W12 who were re-randomized to SC 300mg miri Q4W during maintenance; LSM = least squares mean; NI = SES-CD non-improver (a patient who received miri during induction who did not achieve a ≥1-point improvement in SES-CD at W12); PBO = placebo; SC = subcutaneous; SD = standard deviation; SE = standard error; W = week. For statistical comparisons across induction treatment groups, a mixed model for repeated measures was used. The model includes treatment, region, prior biologic CD therapy used, baseline, visit and baseline by visit, and treatment by visit.p-values versus PBO: *p< 0.05; ** p≤0.001. Bolded values are statistically different versus PBO.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,003 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».