Janssen presents results of biologic therapies in patients with Crohn’s Disease

The SEAVUE study examined a total of 386 patients with moderately to severely active CD patients 

The Janssen Pharmaceutical Companies of Johnson & Johnson recently announced efficacy and safety data for STELARA (ustekinumab) in Crohn’s disease (CD) and ulcerative colitis (UC),1-4 including data from the SEAVUE study, the first head-to-head study of biologic therapies in patients with CD, presented in a Clinical Science Late-Breaking Abstract Plenary session.

SEAVUE data showed treatment with STELARA demonstrated high rates of clinical remission, corticosteroid-free remission, clinical response and endoscopic response through one year in biologic-naïve patients with moderately to severely active CD, although the primary endpoint of statistical superiority versus adalimumab was not demonstrated. These head-to-head data are one of 20 abstracts Janssen presented from the Company’s gastroenterology pipeline and portfolio at DDW Virtual 2021, which took place May 21-23.

“As the first head-to-head study of biologic therapies in Crohn’s disease, SEAVUE is filling an important knowledge gap in the gastrointestinal community,” said Bruce E Sands, Chief of the Dr Henry D Janowitz Division of Gastroenterology at Mount Sinai Hospital and the Dr Burrill B. Crohn Professor of Medicine (Gastroenterology), at the Icahn Institute for Medicine at Mount Sinai, and SEAVUE study principal investigator. “SEAVUE has generated data that confirm STELARA as an important option for people living with moderately to severely active Crohn’s disease who are new to biologic therapy.” 

The SEAVUE study examined a total of 386 patients with moderately to severely active CD patients were randomised 1:1 to treatment with STELARA approximately 6 mg/kg intravenous (IV) at baseline, then 90 mg subcutaneous (SC) every eight weeks (q8w), or treatment with adalimumab 160/80 mg SC at baseline/week two, then 40 mg SC every two weeks per the US Food and Drug Administration-approved regimens without dose modifications. 

Results did not show statistically significant differences:

• 64.9 per cent of STELARA-treated patients and 61 per cent of adalimumab-treated patients achieved clinical remission (Crohn’s Disease Activity Index [CDAI] <150) at one year (week 52), the study’s primary endpoint.
• Major secondary endpoints were not significantly different between the groups:
  • 60.7 per cent of STELARA-treated patients and 57.4 per cent of adalimumab-treated patients achieved corticosteroid-free remission.
  • 72.3 per cent of STELARA-treated patients and 66.2 per cent of adalimumab-treated patients achieved clinical response.
  • 56.5 per cent of STELARA-treated patients and 55.4 per cent of adalimumab-treated patients achieved patient-reported outcome (PRO)-2 symptom remission.
  • At week 16, 57.1 per cent of STELARA-treated patients and 60 per cent of adalimumab-treated patients achieved clinical remission.
  • At week 52, in patients with Simple Endoscopic Score for Crohn’s Disease (SES-CD)b ≥3 at baseline, 28.5 per cent of STELARA-treated patients and 30.7 per cent of adalimumab-treated patients achieved endoscopic remission.
• Benefits for both treatments were also demonstrated across additional efficacy endpoints, but did not demonstrate statistically significant differences:
  • At week 52, in patients with SES-CD ≥3 at baseline, 41.9 per cent of STELARA-treated patients and 36.9 per cent of adalimumab-treated patients achieved an endoscopic response.
  • Clinical response achieved at week 16 was maintained at week 52 in 88.6 per cent of STELARA-treated patients and 78 per cent of adalimumab-treated patients.
  • The mean change from baseline to week 52 in the number of liquid/soft stools in the prior seven days was -19.9 for STELARA-treated patients and -16.2 for adalimumab-treated patients. The mean change from baseline to week 52 in the sum of the number of liquid/soft stools and abdominal pain scores in the prior seven days was -29.6 for STELARA-treated patients and -25.1 for adalimumab-treated patients.
• Safety results were consistent with prior experience for both treatments. Discontinuation rates were numerically lower for STELARA-treated patients (15.2 per cent) versus adalimumab-treated patients (23.6 per cent) who discontinued before week 52. Among STELARA-treated patients and adalimumab-treated patients, 6.3 per cent and 11.3 per cent had adverse events (AEs) that led to discontinuation of study drug, respectively.

“Until now, there have been no head-to-head trials comparing the safety and efficacy of prescription biologics to treat CD, a chronic condition that can cause persistent and debilitating symptoms which can have a profound impact on a person’s daily life,” said Andrew Greenspan, Vice President, Immunology Medical Affairs, Janssen Scientific Affairs. “Armed with this new clinical trial data, doctors have a compelling option in STELARA for appropriate patients living with Crohn’s disease.”