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SERENE ER Analysis Part 2 SERENE-UC: Exposure-response Analysis of Higher Versus Standard Adalimumab Dosing Regimens for Patients with Moderately to Severely Active Ulcerative Colitis.
- Source :
-
Clinical pharmacology in drug development [Clin Pharmacol Drug Dev] 2024 Sep; Vol. 13 (9), pp. 1033-1043. Date of Electronic Publication: 2024 Jul 02. - Publication Year :
- 2024
-
Abstract
- SERENE UC (NCT02065622) evaluated whether a higher adalimumab induction regimen improved patients with ulcerative colitis (UC) response, but a flat dose-response relationship was found in the induction study. We investigated exposure-response (ER) relationships in induction and maintenance studies considering patients' baseline characteristics. Adalimumab exposures were simulated using the established population pharmacokinetic model. Multivariable logistic regressions were used to assess the efficacy endpoints (clinical remission, endoscopic remission, endoscopic improvement) at weeks 8 and 52. In the induction study, an increasing ER trend with heterogeneity between induction regimens was shown, suggesting average concentration (C <subscript>avg</subscript> ) had a significant impact on primary efficacy endpoints within each group. However, data were not described by a single ER curve. Using inverse effective clearance as the exposure metric described trends across induction regimens with a single curve. Patients with inherently lower effective adalimumab clearance responded better. The patient response rates at week 52 showed no heterogeneity. A short-term increase in adalimumab dose did not drive better responses for induction, and apparent ER relationships were better explained by patient-inherent lower clearance. Conversely, during maintenance up to week 52, increasing the concentration via dose translated to better responses more robustly. The ER findings for SERENE UC were consistent with SERENE CD.<br /> (© 2024, The American College of Clinical Pharmacology.)
- Subjects :
- Humans
Adult
Female
Male
Middle Aged
Severity of Illness Index
Models, Biological
Treatment Outcome
Remission Induction methods
Double-Blind Method
Anti-Inflammatory Agents administration & dosage
Anti-Inflammatory Agents pharmacokinetics
Young Adult
Adalimumab administration & dosage
Adalimumab pharmacokinetics
Colitis, Ulcerative drug therapy
Dose-Response Relationship, Drug
Subjects
Details
- Language :
- English
- ISSN :
- 2160-7648
- Volume :
- 13
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Clinical pharmacology in drug development
- Publication Type :
- Academic Journal
- Accession number :
- 38953600
- Full Text :
- https://doi.org/10.1002/cpdd.1437