For maintenance treatment in patients with active ulcerative colitis (UC), a higher dose of upadacitinib 30mg (UPA30) indicated greater clinical benefit than upadacitinib 15 mg (UPA15), Brian Feagan, MD, said during his abstract presentation at the 2022 ACG Annual Scientific Meeting and Postgraduate Course on October 24, in Charlotte, North Carolina.

Dr Feagan is a professor of medicine at the Schulich School of Medicine & Dentistry, a gastroenterologist at London Health Sciences Centre and senior scientific director of Alimentiv Inc in London, Ontario, Canada.

Presenting the abstract cited for the Outstanding Research Award in the inflammatory bowel disease category, Dr Feagan reviewed results of the U-ACHIEVE maintenance trial that he and colleagues conducted, which evaluated the benefits of UPA30 vs UPA15 once daily as maintenance treatment in patients with moderate to severe UC.

For the post-hoc analysis, the clinical responses of 451 patients were recorded at weeks 8 and 52 after they were randomized to UPA15 (n=149), UPA30 (n=148), or placebo (n=154). To calculate the number of weeks spent in remission, the investigators used the partial adapted Mayo score.

At the beginning of the trial (week 0), 91% of patients exhibited mild disease symptoms. By the end of 52 weeks maintenance, 19.7% more patients taking UPA30 exhibited lesser disease severity than patients taking UPA15. Patients taking the higher dose were in clinical remission for a longer time (34.4 weeks) than those taking a lower dose (30.5 weeks) or placebo (15.8 weeks). Furthermore, after a year of maintenance, patients taking the higher dose stayed in remission for an additional 26.9 days than those on a lower dose.

Similar results were observed among patients under 65 years of age. The investigators found that out of 411 patients, 26% more patients taking UPA30 experienced lesser disease severity vs those taking UPA15 and placebo. Also, they were in “clinical remission for an additional 29.3 days over a year of maintenance vs UPA15.”

Based on the findings, after 52 weeks of maintenance treatment, patients taking UPA30 mg “indicated clinical benefit of high dose upadacitinib as maintenance treatment in UC.”

—Priyam Vora

Reference:
Feagan B. 1 - Benefits of high versus low dose upadacitinib as maintenance treatment in ulcerative colitis patients who were responders to 8-week induction with upadacitinib: Results from the U-ACHIEVE phase 3 maintenance trial. Oral paper presentation. Presidential plenary session 1. Presented at: ACG 2022 Annual scientific meeting and Postgraduate course. Charlotte, North Carolina. October 24, 2022.