P3315 - Mirikizumab Provides Sustained Long-Term Efficacy Up to 4 Years of Treatment for Ulcerative Colitis: Final Results From the LUCENT-3 Open-Label Extension Study
IBD Unit, Guy’s and St Thomas’ Hospital, London, UK London, England, United Kingdom
Bruce E. Sands, MD, MS, FACG1, David B.. Clemow, PhD2, Geert R. D’Haens, MD, PhD3, Severine Vermeire, MD, PhD4, Peter M. Irving, MD5, Taku Kobayashi, 6, Laurent Peyrin-Biroulet, MD, PhD7, Karen Samaan, 2, Anil Gaur, 2, Jerome Paulissen, 2, Sarah Folian, 2, Ravneet Arora, 2, Nicholas Paquette, 8, Richard E.. Moses, DO, JD2, Axel Dignass, MD, PhD9 1Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA, New York, NY; 2Eli Lilly and Company, Indianapolis, IN; 3Department of Gastroenterology, Amsterdam University Medical Center, Amsterdam, Noord-Holland, Netherlands; 4Department of Gastroenterology & Hepatology, University hospital Leuven, Leuven, Brabant Wallon, Belgium; 5IBD Unit, Guy’s and St Thomas’ Hospital, London, UK, London, England, United Kingdom; 6Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Tokyo, Japan; 7Department of Gastroenterology, CHRU Nancy, INSERM NGERE, Université de Lorraine, France, Vandœuvre-lès-Nancy, Lorraine, France; 8Syneos Health, Morrisville, NC; 9Agaplesion Markus Hospital, Frankfurt, Hessen, Germany Introduction: Mirikizumab, a p19-directed interleukin-23 monoclonal antibody, is efficacious in inducing clinical remission at Week (W) 12 and maintaining clinical remission through W152 in moderately-to-severely active ulcerative colitis. Here, we present efficacy and safety results through W212 of mirikizumab treatment from the open-label extension LUCENT-3 study. Methods: Symptomatic, clinical, endoscopic, histologic, corticosteroid-free (CSF), bowel urgency, quality-of-life, and adverse event (AE) outcomes are reported for mirikizumab induction responders, including patients with biologic failure, who entered LUCENT-3, with data shown for W52 maintenance remitters. Discontinuations or missing data were handled by nonresponder imputation (NRI), modified NRI (mNRI), and observed case (OC). mNRI uses multiple imputation for missing data and balances bias of NRI and OC. Table 1 provides endpoint and population definitions and abbreviations for maintenance remitters. Safety population N=339. Results: Using mNRI (N=179), among W52 mirikizumab maintenance remitters demonstrated clinical response in 79% at W212. W212 remission rates among W52 clinical remitters were 77% for symptomatic, 62% for clinical, 66% for endoscopic, 53% for histologic-endoscopic mucosal, 62% for CSF, and 60% for bowel urgency; 78% for Inflammatory Bowel Disease Questionnaire (IBDQ) response, and 73% IBDQ remission. Histologic-endoscopic mucosal improvement and bowel urgency clinically meaningful improvement at W212 were achieved in 54% and 75% of patients, respectively. Biologic Failed/Not Biologic Failed subgroup data demonstrated maintenance of efficacy (Table 1). Stool frequency, rectal bleeding, bowel urgency, and abdominal pain symptom score reductions from induction baseline at W52 were sustained through W212. For W0-160 of LUCENT-3, serious AEs were reported in 12% patients, while 7% discontinued treatment due to an AE. AEs of special interest: opportunistic infection (4.4%), cerebrocardiovascular events (1.5%), and malignancy (1.5%). Liver enzymes ≥3 upper limit of normal (ULN) included alanine aminotransferase (2%) and aspartate aminotransferase (1%); total bilirubin level was ≥2 ULN (2%). Discussion: Mirikizumab provides long-term symptomatic, clinical, endoscopic, histologic, corticosteroid-free, and quality-of-life sustained and durable maintenance of benefits up to 4 years in patients with UC, including for biologic failed patients, with no new safety concerns.
Figure: Summary of Mirikizumab Efficacy at Week 212 in Week 52 Remitters.
Bruce E. Sands, MD, MS, FACG1, David B.. Clemow, PhD2, Geert R. D’Haens, MD, PhD3, Severine Vermeire, MD, PhD4, Peter M. Irving, MD5, Taku Kobayashi, 6, Laurent Peyrin-Biroulet, MD, PhD7, Karen Samaan, 2, Anil Gaur, 2, Jerome Paulissen, 2, Sarah Folian, 2, Ravneet Arora, 2, Nicholas Paquette, 8, Richard E.. Moses, DO, JD2, Axel Dignass, MD, PhD9. P3315 - Mirikizumab Provides Sustained Long-Term Efficacy Up to 4 Years of Treatment for Ulcerative Colitis: Final Results From the LUCENT-3 Open-Label Extension Study, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.