Golimumab Trough Levels in Patients With Ulcerative Colitis
NCT ID: NCT03773445
Last Updated: 2022-04-15
Study Results
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Basic Information
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COMPLETED
52 participants
OBSERVATIONAL
2019-03-01
2021-09-30
Brief Summary
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Detailed Description
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Reactive therapeutic drug monitoring of anti-TNF agents may help to identify mechanisms for loss of response and to guide selection of optimal intervention in individual patients and has been shown to be cost-effective compared with empiric dose escalation. Proactive therapeutic drug monitoring showed that anti-TNF trough levels are correlated with clinical response, clinical remission and mucosal healing in patients with inflammatory bowel disease (IBD). Conversely, inadequate serum drug concentrations and antidrug antibodies are associated with poor clinical outcomes. Recently, a study demonstrated that infliximab trough concentrations during maintenance therapy are associated with endoscopic and histologic healing in patients with UC.
Golimumab, a subcutaneously administered fully human antibody to TNF, induces clinical response and remission in patients with moderately to severely active UC. In patients who responded to induction therapy, golimumab doses administered every 4 weeks as a maintenance regimen was effective in maintaining clinical response through 1 year. Available data on golimumab drug monitoring and exposure-response relationship in UC patients are from the PURSUIT trials. A positive association between golimumab levels and efficacy outcomes, including mucosal healing, was confirmed during both induction and maintenance portions of the PURSUIT studies.
Real life data regarding golimumab concentrations and clinical outcomes are lacking, with only a small observational study published. Besides, there are no data regarding the ability of golimumab to achieve histological remission in UC patients.
Conditions
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Study Design
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COHORT
CROSS_SECTIONAL
Interventions
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Golimumab trough levels
Golimumab trough levels taken immediately before the administration of the next subcutaneous dose of golimumab
Antibodies to golimumab
Antibodies to golimumab taken immediately before the administration of the next subcutaneous dose of golimumab
Histology
Histology of colonic biopsies using the Geboes Index
Colonoscopy
Colonoscopy to evaluate the endoscopic activity by a Mayo endoscopic subscore
Eligibility Criteria
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Inclusion Criteria
* Patients with a diagnosis of ulcerative colitis at least 12 months prior to the start of the study.
* Patients previously treated with golimumab for ulcerative colitis prescribed according to the usual clinical practice of each center and who have received at least 5 maintenance doses according to the guidelines accepted in the technical file.
* Sign of informed consent.
Exclusion Criteria
* Alterations in the coagulation that contraindicate the taking of biopsies
* Patients with moderate-severe heart failure (grades III / IV NYHA)
* Patients with tuberculosis or other serious infections such as septicemia, abscesses and opportunistic infections
* Psychiatric illness that discourages participation in the study
* Patients with a history of hypersensitivity to golimumab, to other murine proteins or to any of the excipients included in the golimumab data sheet
* Withdrawal of the informed consent by the patient
* Any other condition that in the opinion of the investigator discourages the participation of the subject in the study.
18 Years
ALL
No
Sponsors
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Hospital Universitario La Fe
OTHER
Hospital Universitario 12 de Octubre
OTHER
Hospital Universitario Ramon y Cajal
OTHER
Gregorio Marañón Hospital
OTHER
Complejo Hospitalario de Navarra
OTHER
Hospital Universitario Fundación Alcorcón
OTHER
Hospital Infanta Sofia
OTHER
Hospital Clínico Universitario de Valencia
OTHER
Puerta de Hierro University Hospital
OTHER
Hospital Universitario La Paz
OTHER
Hospital Universitario de Fuenlabrada
OTHER
Merck Sharp & Dohme LLC
INDUSTRY
Hospital San Carlos, Madrid
OTHER
Responsible Party
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Carlos Taxonera
Dr.
Principal Investigators
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Carlos Taxonera, Dr.
Role: PRINCIPAL_INVESTIGATOR
Hospital San Carlos, Madrid
Locations
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Hospital Universitario Fundación Alcorcón
Alcorcón, Madrid, Spain
Hospital Universitario Fuenlabrada
Fuenlabrada, Madrid, Spain
Hospital Puerta de Hierro
Majadahonda, Madrid, Spain
Hospital Infanta Sofia
San Sebastián de los Reyes, Madrid, Spain
Complejo Hospitalario de Navarra
Pamplona, Navarre, Spain
Hospital Gregorio Marañón
Madrid, , Spain
Hospital Universitario Ramon y Cajal
Madrid, , Spain
Hospital Clinico San Carlos
Madrid, , Spain
Hospital 12 de Octubre
Madrid, , Spain
Hospital Universitario La Paz
Madrid, , Spain
Hospital Clínico Universitario de Valencia
Valencia, , Spain
Hospital Universitario La Fe
Valencia, , Spain
Countries
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References
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Rutgeerts P, Sandborn WJ, Feagan BG, Reinisch W, Olson A, Johanns J, Travers S, Rachmilewitz D, Hanauer SB, Lichtenstein GR, de Villiers WJ, Present D, Sands BE, Colombel JF. Infliximab for induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2005 Dec 8;353(23):2462-76. doi: 10.1056/NEJMoa050516.
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Vande Casteele N, Khanna R, Levesque BG, Stitt L, Zou GY, Singh S, Lockton S, Hauenstein S, Ohrmund L, Greenberg GR, Rutgeerts PJ, Gils A, Sandborn WJ, Vermeire S, Feagan BG. The relationship between infliximab concentrations, antibodies to infliximab and disease activity in Crohn's disease. Gut. 2015 Oct;64(10):1539-45. doi: 10.1136/gutjnl-2014-307883. Epub 2014 Oct 21.
Papamichael K, Rakowsky S, Rivera C, Cheifetz AS, Osterman MT. Infliximab trough concentrations during maintenance therapy are associated with endoscopic and histologic healing in ulcerative colitis. Aliment Pharmacol Ther. 2018 Feb;47(4):478-484. doi: 10.1111/apt.14458. Epub 2017 Dec 6.
Sandborn WJ, Feagan BG, Marano C, Zhang H, Strauss R, Johanns J, Adedokun OJ, Guzzo C, Colombel JF, Reinisch W, Gibson PR, Collins J, Jarnerot G, Rutgeerts P; PURSUIT-Maintenance Study Group. Subcutaneous golimumab maintains clinical response in patients with moderate-to-severe ulcerative colitis. Gastroenterology. 2014 Jan;146(1):96-109.e1. doi: 10.1053/j.gastro.2013.06.010. Epub 2013 Jun 14.
Adedokun OJ, Xu Z, Marano CW, Strauss R, Zhang H, Johanns J, Zhou H, Davis HM, Reinisch W, Feagan BG, Rutgeerts P, Sandborn WJ. Pharmacokinetics and Exposure-response Relationship of Golimumab in Patients with Moderately-to-Severely Active Ulcerative Colitis: Results from Phase 2/3 PURSUIT Induction and Maintenance Studies. J Crohns Colitis. 2017 Jan;11(1):35-46. doi: 10.1093/ecco-jcc/jjw133. Epub 2016 Jul 20.
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Provided Documents
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Document Type: Study Protocol
Document Type: Informed Consent Form
Other Identifiers
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CTS-GOL-2018-01
Identifier Type: -
Identifier Source: org_study_id
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