S0645 Efficacy and Safety of Ustekinumab for Crohn's Disease Through 5 Years: Final Results From the IM-UNITI Long-Term Extension
Bibliographic record
Abstract
INTRODUCTION: Ustekinumab (UST) is approved for treatment of moderate-to-severely active Crohn's disease (CD) and ulcerative colitis. Here we report final results of the IM-UNITI long-term extension (LTE) study, with efficacy and safety through 5 years (yrs) of subcutaneous (SC) UST treatment. METHODS: 1281 patients (pts) entered the maintenance study, including 397 IV UST induction responders, randomized to either SC placebo [PBO], n = 133; UST 90 mg q12w, n = 132; or UST 90 mg q8w, n = 132. Additional nonrandomized pts were assigned to receive UST 90 mg q12w (PBO induction non-responder), UST 90 mg q8w (delayed Wk16 responder to UST), or PBO (PBO induction responder). All pts who entered the LTE at Wk44 continued the same treatment regimen they were receiving at Wk44, including 567 UST-treated pts (237 randomized). 151 PBO-treated pts terminated study participation after study unblinding and analysis of the Wk44 data. RESULTS: Among all pts originally randomized in the maintenance study (ITT analysis), 28.7% and 34.4% of pts were in clinical remission 5 yrs later, at Wk252, on 90 mg UST q12w and q8w, respectively. Approximately half (51.1%) of the pts who entered the LTE completed their final dosing visit. Key results after 5 yrs among pts who entered the LTE, including response and remission overall and in anti-TNF therapy history subsets, are summarized in Table 1. Of the pts who were in clinical remission at wk252, 89.5% who received continuous q12w (34/38) and 93.3% who received continuous q8w (42/45) were not receiving steroids. Antibody to UST rates through Wk272 remained low, occurring in 5.8% (31/532) of randomized pts continuously receiving UST in the LTE (excluding randomized PBO dose adjusters). Safety events (per hundred pt-yrs) were not higher among all UST-treated pts entering the LTE compared with PBO from Wk0 through Wk272 (Table 2). No new deaths were reported after Wk156 (6 reported previously). Six pts had malignancies (excluding NMSC) between Wks156 and 272 (q12w: intraocular melanoma, renal cell carcinoma; q8w: endometrial adenocarcinoma, lentigo maligna melanoma, lobular breast cancer in situ, pancreatic carcinoma). CONCLUSION: Pts receiving SC UST generally maintained clinical response and remission through 5 yrs. Nearly half of anti-TNF-naive pts who responded to UST IV induction were in remission after 5 yrs of SC q8w maintenance treatment. No new safety signals were observed.Table 1Table 2
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".