P0800 Efficacy of filgotinib in patients with ulcerative colitis refractory to prior biologics
Bibliographic record
Abstract
Abstract Background Filgotinib has shown promise for patients with moderate-to-severe Ulcerative Colitis (UC) who are refractory to prior biologics. Given the need for effective alternatives in this challenging patients, this study examines the efficacy of filgotinib in biologic-refractory patients. Methods An observational, descriptive, ambispective, single-center study of 29 patients with active UC who were started on filgotinib 200mg/24h between October 2018 and May 2024. Clinical and biochemical variables analyzed: partial Mayo Score (PMS), endoscopic evaluation, fecal calprotectin (FC) and the adjuvant treatment-free response (corticosteroids or apheresis) at weeks 8, 16, 26 and 52. Other variables were also measured: disease characteristics, previous biologic treatments and concomitant use of corticosteroids and immunomodulators. Results The median age was 43 (IQR 32-53) years, 45% were women. The median disease duration was 7 (IQR 3-14) years. One patient smoked at the beginning of treatment, and ten were ex-smokers. 45% had extensive colitis (E3, according to Montreal classification), and 55% had left-sided colitis. In 13 patients, colonoscopy was performed prior to drug initiation, with 92% presenting an endoscopic Mayo score 2-3. The most unique feature of our cohort is the high refractoriness to previous biologic treatments. Only one patient was naïve to biologics, as he was not a candidate for anti-TNF due to a history of multiple sclerosis. Of the remaining 28 patients, the majority (97%) had failed anti-TNF treatment, 41% had also failed ustekinumab and 34% had failed vedolizumab. At the time of treatment initiation, 45% were receiving concomitant oral or intravenous corticosteroids. In terms of baseline disease activity, the median PMS was 6 (IQR 5-7), and the median FC was 2000 (IQR 1664-2000) µg/g. Median follow-up was 26 (8-52) weeks. At weeks 8, 16, 26 and 52, the clinical response (PMS reduction ≥2) and clinical remission (PMS ≤1) rates were 83%/45%, 80%/64%, 72%/56% and 62%/47%, respectively (image 1). There was a significant decrease in FC: 1124 (IQR 155-2000) µg/g, 860 (IQR 53-2000) µg/g, 187 (IQR 82-1107) µg/g and 165 (IQR 17-1910) µg/g at weeks 8, 16, 26 and 52, respectively. Adjuvant treatment-free response was 43% with an estimated Kaplan-Meier curve persistence of 48% at 1 year (image 2.1). During follow-up, filgotinib was discontinued in 7 patients, 4 of them in the first 8 weeks. Attached is the Kaplan-Meier curve for the persistence of Filgotinib (image 2.2) estimated at 72% at 1 year. Conclusion Filgotinib is effective in the treatment of biologic-refractory ulcerative colitis in selected patients, achieving a high clinical remission rate and significantly reducing the need for adjuvant treatment.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".