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THU0173 Long term safety and efficacy of filgotinib in a phase 2B open label extension study in patients with rheumatoid arthritis: results up to 144 weeks
  1. R Alten1,
  2. R Westhovens2,
  3. A Kavanaugh3,
  4. M Genovese4,
  5. K Winthrop5,
  6. M Greenwald6,
  7. L Ponce7,
  8. F Enriquez8,
  9. M Stanislavchuk9,
  10. M Mazur10,
  11. A Spindler11,
  12. R Cseuz12,
  13. N Nikulenkova13,
  14. M Glowacka-Kulesz14,
  15. I Szombati15,
  16. A Dudek16,
  17. L Meuleners17,
  18. C Tasset17,
  19. P Harrison17,
  20. A Van der Aa17
  1. 1Schlosspark-Klinik, Berlin, Germany
  2. 2University Hospitals, Leuven, Belgium
  3. 3University of California, la Jolla
  4. 4Stanford University School of Medicine, Palo Alto
  5. 5Oregon Health and Science University, Portland
  6. 6Desert Medical Advances, Palm Springs, United States
  7. 7Cons. Priv., Temuco, Chile
  8. 8Clinstile SA de CV, Col.Roma, Mexico
  9. 9Vinnitsya Reg Clin Hosp, Vinnitsya, Ukraine
  10. 10IMSP Inst. de Cardiologie, Chisinau, Moldova, Republic of
  11. 11Centro Méd. Priv. Reum., Tucumau, Argentina
  12. 12Revita Reumatolόgiai Kft, Budapest, Hungary
  13. 13Vladimir Reg Clin Hosp, Shosse, Russian Federation
  14. 14Silesiana Centrum Medyczne, Wroclawska, Poland
  15. 15Qualiclinic Kft, Budapest, Hungary
  16. 16AMED Medical Center, Warsaw, Poland
  17. 17Galapagos NV, Mechelen, Belgium

Abstract

Background Filgotinib (GLPG0634, GS-6034) is an oral JAK1 selective inhibitor with a favorable safety and efficacy profile in two 24-week Phase 2b studies as add-on to methotrexate (DARWIN 1) or as monotherapy (DARWIN 2) in patients with active rheumatoid arthritis (RA). Three daily doses were tested (50mg, 100mg or 200mg) in comparison to placebo.

Objectives To assess long term safety and efficacy of filgotinib 200mg daily in patients from the DARWIN 3 Phase 2 open-label extension study.

Methods Patients who completed DARWIN 1 or 2 and enrolled in DARWIN 3 received filgotinib 200mg once daily or 100mg twice daily, depending on prior treatment assignment. The DARWIN 3 data cut off was when the last patient reached extension Week 60. For safety, all data from the first intake of filgotinib in DARWIN 1/2/3 were analysed (up to 144 weeks).

Results 877 patients participated in DARWIN 1 or 2, 790 completed and 739 entered DARWIN 3 from 22 countries (82% females, mean age 53y). 559 patients (75.6%) completed Week 60, 9.3% discontinued due to positive Quantiferon, 7.8% due to other adverse events, 6.8% for other reasons and 0.3% due to insufficient response. Overall exposure to filgotinib was 1314 patient-years (PYE).

Treatment-emergent adverse events (157.7/100PYE), serious adverse events (5.3/100PYE) and serious infections (1.9/100PYE) occurred at similar rates compared to the core studies, however infections decreased on a percentage basis from 15% (109/739, W0–12) to 5% (25/549, W85–96). 16 cases of Herpes zoster were reported (1.2/100PYE), 6 cases of malignancy (excl. NMSC) (0.5/100PYE) and 1 case of MACE (0.1/100PYE). There was no active case of tuberculosis. Three fatalities were reported (0.2/100PYE). Mean change from baseline (CFB) at Week 96 and CTCAE toxicity grading in lab parameters of special interest are shown in table 1.

Table 1.

Mean CFB at Week 96 and CTCAE toxicity grading of selected lab parameters

Based on an observed case analysis 84% (505/601), 65% (389/601), 44% (267/601) and 51% (299/587) of patients reached ACR20, ACR50, ACR70 and DAS28(CRP) remission at Week 60 respectively.

Conclusions With 1314 patient-years of exposure, the safety profile of filgotinib appears consistent with that of previously reported double-blind studies and the clinical response appears durable.

References

  1. Westhovens R et al. Ann Rheum Dis 2016;0:1–11.

  2. Kavanaugh A et al. Ann Rheum Dis 2016;0:1–11.

References

Disclosure of Interest R. Alten Grant/research support from: Galapagos, R. Westhovens Grant/research support from: Roche, Consultant for: Galapagos, Speakers bureau: BMS, A. Kavanaugh Consultant for: Galapagos, Pfizer, AbbVie, Amgen, Celgene, Janssen, Novartis, Eli Lilly, UCB, M. Genovese Grant/research support from: Abbvie, Eli Lilly, Pfizer, Astellas, Vertex, Consultant for: Galapagos, Gilead, Abbvie, Eli Lilly, Pfizer, Astellas, Vertex, K. Winthrop Grant/research support from: BMS, Pfizer, Consultant for: pfizer, BMS, lilly, Abbvie, Roche, UCB, Galapagos, Amgen, M. Greenwald Grant/research support from: Abbvie,Amgen, Bristol Myers Squibb, Celgene, Galapagos, Gilead, Lilly, Merck, Pfizer, UCB, Consultant for: Lilly, Pfizer, L. Ponce: None declared, F. Enriquez: None declared, M. Stanislavchuk: None declared, M. Mazur: None declared, A. Spindler: None declared, R. Cseuz: None declared, N. Nikulenkova: None declared, M. Glowacka-Kulesz: None declared, I. Szombati: None declared, A. Dudek: None declared, L. Meuleners Employee of: Galapagos NV, C. Tasset Employee of: Galapagos NV, P. Harrison Employee of: Galapagos NV, A. Van der Aa Employee of: Galapagos NV

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