P544 Patients with moderate to severe Crohn’s disease with and without prior biologic failure demonstrated improved clinical outcomes with risankizumab: Results from phase 3 induction and maintenance trials
Bibliographic record
Abstract
Abstract Background Risankizumab (RZB), a selective interleukin-23 inhibitor, demonstrated superior efficacy over placebo (PBO) as induction and maintenance therapy in patients with moderate to severe Crohn’s disease (CD). Here we compared the efficacy and safety of RZB in inducing and maintaining clinical remission and clinical response in patients with CD who demonstrated intolerance and/or inadequate response (IR) to biologic therapies (with prior bio-failure) versus those who demonstrated IR to conventional therapies only (without prior bio-failure). Methods This subgroup analysis included pooled induction data from patients randomized to receive intravenous (IV) RZB 600mg (N=527) or placebo (PBO) IV (N=362) every 4 weeks (wks) for 12wks in the ADVANCE+MOTIVATE studies, and maintenance data from IV RZB responders who were randomized to subcutaneous (SC) RZB 360mg (N=141) or withdrawn from RZB to receive PBO SC (withdrawal [PBO SC], N=164) every 8wks for 52wks in FORTIFY. Clinical remission (per CDAI and per stool frequency [SF]/abdominal pain score [APS]), CDAI clinical response, enhanced SF/APS clinical response, and maintenance of clinical remission were evaluated in the overall population, and in subgroups with and without prior bio-failure, using non-responder imputation. Only descriptive statistics were used for the subpopulations (Endpoints are defined in Table footnotes). Safety was assessed throughout the studies. Results Approximately three-quarters of randomized patients included in the subgroup analyses had prior bio-failure (ADVANCE+MOTIVATE: 75.4%; FORTIFY: 73.8%). Among the subpopulations, numerically higher rates of clinical remission (CDAI and SF/APS), CDAI clinical response, and enhanced SF/APS clinical response were observed at the end of induction (wk12) among patients receiving RZB 600mg IV versus PBO IV (Figure); rates were numerically higher in the subpopulation without prior bio-failure than with prior bio-failure. FORTIFY Wk52 response rates for these endpoints, along with maintenance of clinical remission, were higher in the RZB 360mg SC arm compared to the withdrawal (PBO SC) arm in both subpopulations, with numerically higher rates observed for the subgroup without prior bio-failure (Figure). RZB maintenance treatment was well-tolerated and no new safety signals were observed. The safety profile of RZB has been reported previously.1,2 Conclusion Across the induction and maintenance studies, compared to PBO, RZB treatment led to greater clinical remission and clinical response in patients with CD independent of prior biologic experience. The subpopulation without prior bio-failure achieved higher rates of symptomatic remission.
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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 | 0.004 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| 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".