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Edward Loftus, MD, on Upadacitinib in Crohn's Disease

Dr Loftus recaps his poster presentation on a subanalysis from the upadacitinib phase 3 trials in Crohn's disease examining the effect on anxiety, depression, fatigue, and bowel urgency. 

 

Edward V. Loftus, Jr., M.D. is the Maxine and Jack Zarrow Family Professor of Gastroenterology Specifically in IBD at the Mayo Clinic College of Medicine and Science in Rochester, Minnesota

 

Hi, I'm Ed Loftus at Washington DC at DDW and I wanted to talk to you about one of the posters that I presented yesterday. And this poster was a sub-analysis from the upadacitinib Crohn's disease phase 3 trials.

And what we did was we looked at the several IBDQ questions— remember IBDQ is 32 questions, and patients ranked those answers on a 1 to 7 scale. And we were looking particularly at 4 items: fatigue, bowel urgency, anxiety, and depression. And we actually tracked those over time.

And we grouped together, if the patient said they always had this often or sometimes or a good bit of the time, so the top 4 answers, we looked at the percentage of patients who said yes to those. And what we found was that in the induction trial, by week 12, the 45 milligrams of upadacitinib was associated with significant reductions in, again, bowel urgency, anxiety, depression, and fatigue as measured by that IBDQ score. Now, the second part of the study was looking at the maintenance, the week 52 data, and there we saw the same thing.

Both the 15 and the 30 milligram treatment arms had significant reductions compared to baseline on those same 4 items of bowel urgency, fatigue, anxiety, and depression. So, you know, we kind of know this from clinic, right? Crohn's disease is not just a gastrointestinal problem, it's a systemic problem. And so, this all contributes to patient's quality of life.

So if we can reduce their fatigue, let them do their activities of the day, we can reduce their bowel urgency so that they can actually leave their house. And then if we get those symptoms under control, it's going to reduce their anxiety and depression. And so I think it just speaks to the potency of upadacitinib as a treatment for Crohn's disease.

So thank you.

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