Efficacy, Safety, Pharmacokinetics, and Pharmacodynamics of Filgotinib, a Selective JAK-1 Inhibitor, After Short-Term Treatment of Rheumatoid Arthritis: Results of Two Randomized Phase IIa Trials
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VANHOUTTE, Frederic P., MAZUR, Minodora, VOLOSHYN, Oleksandr I., STANISLAVCHUK, Mykola, VAN DER AA, Annegret, NAMOUR, Florence, GALIEN, Rene, MEULENERS, Luc, VAN'T KLOOSTER, Gerben. Efficacy, Safety, Pharmacokinetics, and Pharmacodynamics of Filgotinib, a Selective JAK-1 Inhibitor, After Short-Term Treatment of Rheumatoid Arthritis: Results of Two Randomized Phase IIa Trials. In: Arthritis and Rheumatology, 2017, nr. 10(69), pp. 1949-1959. ISSN 2326-5191. DOI: https://doi.org/10.1002/art.40186
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Arthritis and Rheumatology
Numărul 10(69) / 2017 / ISSN 2326-5191

Efficacy, Safety, Pharmacokinetics, and Pharmacodynamics of Filgotinib, a Selective JAK-1 Inhibitor, After Short-Term Treatment of Rheumatoid Arthritis: Results of Two Randomized Phase IIa Trials

DOI:https://doi.org/10.1002/art.40186

Pag. 1949-1959

Vanhoutte Frederic P.1, Mazur Minodora2, Voloshyn Oleksandr I.3, Stanislavchuk Mykola4, Van Der Aa Annegret1, Namour Florence5, Galien Rene5, Meuleners Luc1, Van't Klooster Gerben1
 
1 Galapagos NV, Mechelen,
2 ”Nicolae Testemițanu” State University of Medicine and Pharmacy,
3 Chernivtsi Regional Clinical Hospital, Chernivtsi,
4 Vinnytsia Regional Clinical Hospital,
5 Galápagos SASU, Romainville
 
 
Disponibil în IBN: 7 februarie 2018


Rezumat

Objective: JAK inhibitors have shown efficacy in rheumatoid arthritis (RA). We undertook this study to test our hypothesis that selective inhibition of JAK-1 would combine good efficacy with a better safety profile compared with less selective JAK inhibitors. Methods: In two 4-week exploratory, double-blind, placebo-controlled phase IIa trials, 127 RA patients with an insufficient response to methotrexate (MTX) received filgotinib (GLPG0634, GS-6034) oral capsules (100 mg twice daily or 30, 75, 150, 200, or 300 mg once daily) or placebo, added onto a stable regimen of MTX, to evaluate safety, efficacy, pharmacokinetics (PK), and pharmacodynamics (PD) of filgotinib. The primary efficacy end point was the number and percentage of patients in each treatment group meeting the American College of Rheumatology 20% improvement criteria (achieving an ACR20 response) at week 4. Results: Treatment with filgotinib at 75–300 mg met the primary end point and showed early onset of efficacy. ACR20 response rates progressively increased to week 4, and the Disease Activity Score in 28 joints using the C-reactive protein (CRP) level decreased. Marked and sustained improvements were observed in serum CRP level and other PD markers. The PK of filgotinib and its major metabolite was dose proportional over the 30–300 mg range. Early side effects seen with other less selective JAK inhibitors were not observed (e.g., there was no worsening of anemia [JAK-2 inhibition related], no effects on liver transaminases, and no increase in low-density lipoprotein or total cholesterol). A limited decrease in neutrophils without neutropenia was consistent with immunomodulatory effects through JAK-1 inhibition. There were no infections. Overall, filgotinib was well tolerated. Events related to study drug were mild or moderate and transient during therapy, and the most common such event was nausea. Conclusion: Selective inhibition of JAK-1 with filgotinib shows initial efficacy in RA with an encouraging safety profile in these exploratory studies.

Cuvinte-cheie
antirheumatic agent, filgotinib, Janus kinase 1, triazole derivative,

C reactive protein, methotrexate, pyridine derivative