Article Text
Abstract
Introduction: Interferon γ is a potent proinflammatory cytokine implicated in the inflammation of Crohn’s disease (CD). We evaluated the safety and efficacy of fontolizumab, a humanised anti-interferon γ antibody, in patients with moderate to severe CD.
Methods: A total of 133 patients with Crohn’s disease activity index (CDAI) scores between 250 and 450, inclusive, were randomised to receive placebo or fontolizumab 4 or 10 mg/kg. Forty two patients received one dose and 91 patients received two doses on days 0 and 28. Investigators and patients were unaware of assignment. Study end points were safety, clinical response (decrease in CDAI of 100 points or more), and remission (CDAI ⩽150).
Results: There was no statistically significant difference in the primary end point of the study (clinical response) between the fontolizumab and placebo groups after a single dose at day 28. However, patients receiving two doses of fontolizumab demonstrated doubling in response rate at day 56 compared with placebo: 32% (9/28) versus 69% (22/32, p = 0.02) and 67% (21/31, p = 0.03) for the placebo, and 4 and 10 mg/kg fontolizumab groups, respectively. Stratification according to elevated baseline C reactive protein levels resulted in a decreased placebo response and pronounced differences in clinical benefit. Two grade 3 adverse events were reported and were considered to be related to CD. One death (during sleep) and one serious adverse event (an elective hospitalisation) occurred, both considered unrelated.
Conclusion: Treating active CD with fontolizumab was well tolerated and resulted in increased rates of clinical response and remission compared with placebo.
- CD, Crohn’s disease
- CDAI, Crohn’s disease activity index
- CRP, C reactive protein
- DSMB, Data Safety Monitoring Board
- ELISA, enzyme linked immunosorbent assay
- IFN-γ, interferon γ
- interferon γ
- monoclonal antibody
- fontolizumab
- immunogenicity
- Crohn’s disease
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Supplementary materials
Conflict of interest: DWH is supported by a grant from The Netherlands Organization for Health Research and Development, and is a consultant for Protein Design Labs. GvA is a consultant for Protein Design Labs. SB and TP are employees of Protein Design Labs, Inc. None declared by the other authors.