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S693 Impact of Prior Biologic Exposure on Patient Response to Ozanimod for Moderate-to-Severe Ulcerative Colitis in the Phase 3 True North Study

2021· article· en· W4212848513 on OpenAlexaff
Bruce E. Sands, Dianne Nguyen, Marc Pondel, Michael Silver, AnnKatrin Petersen, Douglas C. Wolf, Remo Panaccione, Edward V. Loftus, Jean‐Frédéric Colombel, Andreas Sturm, Geert D’Haens

Bibliographic record

VenueThe American Journal of Gastroenterology · 2021
Typearticle
Languageen
FieldBiochemistry, Genetics and Molecular Biology
TopicInflammatory Bowel Disease
Canadian institutionsUniversity of Calgary
Fundersnot available
KeywordsMedicineInternal medicineUlcerative colitisCohortPopulationGastroenterologyDisease

Abstract

fetched live from OpenAlex

Introduction: Ozanimod, an oral sphingosine 1-phosphate (S1P) receptor modulator selectively targeting S1P1 and S1P5, demonstrated superior efficacy and safety vs placebo (PBO) for up to 52 weeks (wks) in adults with moderately to severely active ulcerative colitis (UC) in a phase 3 study (True North). In this post-hoc analysis, we evaluated the impact of prior biologic exposure on response to ozanimod. Methods: True North consisted of two cohorts. In cohort 1, patients (pts) with UC received double-blind treatment with once-daily ozanimod HCl 1 mg (equivalent to ozanimod 0.92 mg) or PBO. In cohort 2, pts received open-label once daily ozanimod HCl 1 mg. Ozanimod responders after a 10-wk induction were re-randomized to double-blind maintenance with ozanimod 1 mg or PBO through wk 52 (maintenance). Outcomes based on prior biologic exposure (biologic-naïve, 1 biologic, and 2+ biologics) were analyzed for clinical remission, clinical response, endoscopic improvement, and mucosal healing. Pts exposed to only a JAK inhibitor were excluded. Results: A total of 992 pts (n=213 PBO and n=426 ozanimod in cohort 1, n=353 ozanimod in cohort 2) were included in the analysis for induction; 616 were biologic-naïve, 162 had exposure to 1 biologic, and 214 were exposed to 2 or more biologics. At baseline, biologic-exposed pts had more prior corticosteroid use, longer disease duration, and more extensive disease than biologic-naïve pts. During induction, greater therapeutic effects of ozanimod were generally seen in biologic-naïve vs biologic-exposed pts; however, clinical remission and clinical response were similar for pts exposed to 1 biologic and biologic-naïve pts (Table 1). Compared with PBO, ozanimod-treated pts had greater responses on nearly all endpoints at wk 10 (cohort 1). Proportions were higher with ozanimod in cohort 2 than in cohort 1. During maintenance, ozanimod-treated pts had greater responses on all endpoints versus PBO, with similar proportions of pts achieving clinical response to ozanimod regardless of prior biologic exposure (Table 1). At wk 52, the proportion of pts on ozanimod with clinical remission was similar in the 1-biologic and 2+-biologic exposure groups, and proportions of pts on ozanimod with endoscopic improvement and mucosal healing were similar for the 1-biologic and biologic-naïve groups. Conclusion: Ozanimod improved clinical, endoscopic, and histologic outcomes in both biologic-exposed and -naïve pts. Pts with prior biologic use may require additional time to respond to treatment.Table 1.: Efficacy Outcomes in the Induction and Maintenance Trials.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.001
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.004
Threshold uncertainty score0.016

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0030.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.002
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0010.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0040.000

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.

Opus teacher head0.011
GPT teacher head0.294
Teacher spread0.283 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations3
Published2021
Admission routes1
Has abstractyes

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