Anti-IP-10 antibody (BMS-936557) for ulcerative colitis: a phase II randomised study
- Lloyd Mayer1,
- William J Sandborn2,
- Yuriy Stepanov3,
- Karel Geboes4,
- Robert Hardi5,
- Michael Yellin6,
- Xiaolu Tao7,
- Li An Xu7,
- Luisa Salter-Cid7,
- Sheila Gujrathi7,
- Richard Aranda7,
- Allison Y Luo7
- 1Immunology Institute, Mount Sinai School of Medicine, New York, New York, USA
- 2Division of Gastroenterology, University of California San Diego, La Jolla, California, USA
- 3Dnipropetrovsk State Medical Academy, Dnipropetrovsk, Ukraine
- 4Department of Pathologie, University Hospital KU Leuven, Leuven, Belgium
- 5Chevy Chase Clinical Research, Chevy Chase, Maryland, USA
- 6Medarex Inc, Bloomsbury, New Jersey, USA
- 7Bristol-Myers Squibb, Princeton, New Jersey, USA
- Correspondence to Dr Lloyd Mayer, Immunobiology and Microbiology, Immunology Institute, Mount Sinai School of Medicine, 1425 Madison Avenue, 11th Floor, New York, NY 10029, USA;
- Received 26 July 2012
- Revised 10 January 2013
- Accepted 11 January 2013
- Published Online First 5 March 2013
Objective Interferon-γ-inducible protein-10 (IP-10 or CXCL10) plays a role in inflammatory cell migration and epithelial cell survival and migration. It is expressed in higher levels in the colonic tissue and plasma of patients with ulcerative colitis (UC). This phase II study assessed the efficacy and safety of BMS-936557, a fully human, monoclonal antibody to IP-10, in the treatment of moderately-to-severely active UC.
Design In this 8-week, phase II, double-blind, multicentre, randomised study, patients with active UC received placebo or BMS-936557 (10 mg/kg) intravenously every other week. The primary endpoint was the rate of clinical response at Day 57; clinical remission and mucosal healing rates were secondary endpoints. Post hoc analyses evaluated the drug exposure–response relationship and histological improvement.
Results 109 patients were included (BMS-936557: n=55; placebo: n=54). Prespecified primary and secondary endpoints were not met; clinical response rate at Day 57 was 52.7% versus 35.2% for BMS-936557 versus placebo (p=0.083), and clinical remission and mucosal healing rates were 18.2% versus 16.7% (p=1.00) and 41.8% versus 35.2% (p=0.556), respectively. However, higher BMS-936557 steady-state trough concentration (Cminss) was associated with increased clinical response (87.5% vs 37.0% (p<0.001) for patients with Cminss 108–235 μg/ml vs placebo) and histological improvements (73.0% vs 41.0%; p=0.004). Infections occurred in 7 (12.7%) BMS-936557-treated patients and 3 (5.8%) placebo-treated patients. 2 (3.6%) BMS-936557 patients discontinued due to adverse events.
Conclusions Anti-IP-10 antibody, BMS-936557, is a potentially effective therapy for moderately-to-severely active UC. Higher drug exposure correlated with increasing clinical response and histological improvement. Further dose–response studies are warranted.
Clinical Trial Registration Number: ClinicalTrials.gov NCT00656890.
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