ECCO 2019

Etrasimod (APD334) is an oral, selective sphingosine-1-phosphate receptor modulator. It was evaluated in the randomised, double-blind, placebo-controlled, parallel-group, phase 2 OASIS study in patients with moderately to severely active ulcerative colitis [1]. Etrasimod 2 mg induced significantly higher rates of endoscopic improvement, histological improvement and remission, and mucosal healing in ulcerative colitis patients compared with placebo.

The 156 participants were randomised to once-daily etrasimod 1 mg (n=52), 2 mg (n=50), or placebo (n=54); 90% of patients completed the study. At week 12, etrasimod 2 mg, compared with placebo, resulted in significantly higher rates of:

• endoscopic improvement (43.2% vs 16.3%; P=0.003);
• histological improvement (31.7% vs 10.2%; P=0.006);
• histological remission (19.5% vs 6.1%; P=0.027).

Mucosal healing (defined as both endoscopic improvement and histological remission) was seen in 19.5% and 4.1% of patients treated with etrasimod 2 mg and placebo, respectively (P=0.010). The authors think mucosal healing may prove to be an achievable and objective measure of drug efficacy in ulcerative colitis induction studies.

Keywords: ulcerative colitis, endoscopy