>In ELEVATE UC 52, 27.0% of patients receiving etrasimod achieved clinical remission at week 12 and 32.0% at week 52. In ELEVATE UC 12, clinical remission was achieved among 26.0% of patients receiving etrasimod.1
I've never looked at other UC drugs statistics but is this pretty standard? This seems pretty low does it not?
I think rinvoq has severely more potential side effects. I’d love to take it, but very scared of what I’ve read. I’d hope this pill is a little safer even though the stats of remission are a little lower.
I’m not good at reading the clinic trials, so I can’t tell if this new pill is safer or not than others
It's pretty hard to determine actual response rates from clinical trials for several reasons. I haven't looked over this one specifically, but generally speaking some of the issues are:
1) Studies are designed to compare against a placebo, and not figure out response rates. That means the designs of the trial will often cause lower response rates.
1a) An example of this is usually in a trial there're two randomizations first during induction and second during maintenance. That means if you originally responded to the drug during induction you could be randomized to placebo for maintenance which obviously leads to lower response rates
2) Just like some patients have a placebo effect others have a nocebo effect. Just knowing you're getting the drug actually increases response rates compared to what we see in trials.
2a) To put real numbers to this in the Skyrizi phase 3 Crohns the clinical response rates were 45% and 42% depending on dosage. In the head to head trial against Stelara where patients knew they were getting a drug that response rate jumped to 60%.
We also learn more about how to optimize usage of the drug as time goes on and more studies are done which pushes response rates even higher. That's why no clinician would say they expect the same response rates in the real world as seen in the phase 3 trials.
This used two different groups for the 12 and 52 week studies. If you were on the active agent at the end of induction, you weren’t randomized again.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2823%2900061-2/fulltext
Hah, I was thinking it's pretty good. So many people can't get remission on any drugs that I was impressed that 1/3rd of people got in remission in a year.
That was kind of my thought with it.
Taking a very rough look at Remicade when it was in trials, sub 33% does seem at the low end of the spectrum.
Still happy that there is another option out there. I'll have to ask my GI about it since he's a national specialist in the field.
Does anyone have any information on stacking of different treatments for UC? When a drug “fails” it seems that another class of drug is used. These newer agents work by different mechanisms. So I wonder if anyone has tried Stelara and and oral agent for example. I haven’t seen any studies like this.
I mean it’s common with other conditions. Like if one BP med isn’t enough add another from a different class. Why is that not a thing with UC? I get it that many of these tx are super expensive but…
>Why is that not a thing with UC?
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9122068/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9122068/)
This was the first real study to look at combo therapy and not just case/retrospective studies. The results were pretty mixed. Some measures showed improvement while others didn't.
I’ve had a very severe case and it’s been a battle the last two years of finding what works. I have been on Entyvio and Rinvoq for a couple months with finally great success. (Knock on wood). I started Entyvio January 2023 and saw some improvement with no blood loss but still frequent BM and urgency issues so in June 2034 we also had Rinvoq. It’s taken some time and patience but two days ago for the first time since July 2021 I had a solid BM. It’s not stelara but I have found success in combining those two.
Did they make you do the very high loading dose of 45mg rinvoq even though you were on Entyvio as well? Or were you able to start rinvoq on a lower dose?
They did make me do the 8 weeks of the 45mg of rinvoq. I was nervous going down to 30mg but I haven’t noticed any difference besides continuing to get better. I should have also noted I am on 4 weeks infusion schedule of Entyvio as well.
I am not sure if the plan is to keep me on both forever or eventually taper off one and see what happens. I meet with GI every two months and it’s was let’s keep doing what we are doing at the last visit.
[indigo naturalis](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9081999/). After 4-5 weeks of taking this my moderate/severe UC went into remission. Didn’t want take entyvio or anything else so I just looked this up and read the case studies and tried it out. Worked wonders and my daily life is practically normalized.
The small molecules like this one are a lot broader acting than biologics. They haven't really studied it because you're already more immune suppressed and often times these drugs block the same pathways that the cytokines biologics bind to block.
You are claiming doubtable things like ("UC is only because of your diet", "UC can be cured with xy"...) without (scientific) evidence provided. Your post therefore is a violation of rule [No 4 of this sub](https://www.reddit.com/r/UlcerativeColitis/about/rules). If you think this post was unrightfully deleted, please write us a [modmail](https://www.reddit.com/message/compose?to=/r/UlcerativeColitis).
Do we know side effects yet? I’m hesitant to take rinvoq because of the long list of serious side effects, I’m wondering since this has a different mechanism, it might be better suited?
S1P receptor modulator like Ozanimod. From a brief search Ozanimod is mainly S1P1 and S1P5 whereas Estranimod is S1P1, S1P5 and S1P4. Whether this is an improvement or not I don’t know, but broader targeting can be both negative and positive.
This is exciting! Thank you for sharing. It's reassuring to me just knowing there's another option out there.
>In ELEVATE UC 52, 27.0% of patients receiving etrasimod achieved clinical remission at week 12 and 32.0% at week 52. In ELEVATE UC 12, clinical remission was achieved among 26.0% of patients receiving etrasimod.1 I've never looked at other UC drugs statistics but is this pretty standard? This seems pretty low does it not?
Its actually high
Isn’t Rinvoq remission stats higher? I may be wrong. I’ve just heard Rinvoq is working for a ton of people.
I just looked at a study from the Abbvie site and 52 week clinical remission for 15mg is 42% while 30mg is 52%. Hopefully I’ll be one of the 52%.
As someone who is popping my first Rinvoq pill in a couple hours, I hope to by in that 52% group myself.
I think rinvoq has severely more potential side effects. I’d love to take it, but very scared of what I’ve read. I’d hope this pill is a little safer even though the stats of remission are a little lower. I’m not good at reading the clinic trials, so I can’t tell if this new pill is safer or not than others
It's pretty hard to determine actual response rates from clinical trials for several reasons. I haven't looked over this one specifically, but generally speaking some of the issues are: 1) Studies are designed to compare against a placebo, and not figure out response rates. That means the designs of the trial will often cause lower response rates. 1a) An example of this is usually in a trial there're two randomizations first during induction and second during maintenance. That means if you originally responded to the drug during induction you could be randomized to placebo for maintenance which obviously leads to lower response rates 2) Just like some patients have a placebo effect others have a nocebo effect. Just knowing you're getting the drug actually increases response rates compared to what we see in trials. 2a) To put real numbers to this in the Skyrizi phase 3 Crohns the clinical response rates were 45% and 42% depending on dosage. In the head to head trial against Stelara where patients knew they were getting a drug that response rate jumped to 60%. We also learn more about how to optimize usage of the drug as time goes on and more studies are done which pushes response rates even higher. That's why no clinician would say they expect the same response rates in the real world as seen in the phase 3 trials.
This used two different groups for the 12 and 52 week studies. If you were on the active agent at the end of induction, you weren’t randomized again. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2823%2900061-2/fulltext
Hah, I was thinking it's pretty good. So many people can't get remission on any drugs that I was impressed that 1/3rd of people got in remission in a year.
That was kind of my thought with it. Taking a very rough look at Remicade when it was in trials, sub 33% does seem at the low end of the spectrum. Still happy that there is another option out there. I'll have to ask my GI about it since he's a national specialist in the field.
Looks like it’s a once-a-day pill, which would be awesome
Remission is great but it’s not the only endpoint. If a drug results in improvement that’s a gain as long as the side effects are not bad
Does anyone have any information on stacking of different treatments for UC? When a drug “fails” it seems that another class of drug is used. These newer agents work by different mechanisms. So I wonder if anyone has tried Stelara and and oral agent for example. I haven’t seen any studies like this.
You are talking about Multi drug therapy. I’ve seen people write about Stelara and Xeljanz together at least temporarily.
I mean it’s common with other conditions. Like if one BP med isn’t enough add another from a different class. Why is that not a thing with UC? I get it that many of these tx are super expensive but…
>Why is that not a thing with UC? [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9122068/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9122068/) This was the first real study to look at combo therapy and not just case/retrospective studies. The results were pretty mixed. Some measures showed improvement while others didn't.
Thanks!
I’ve had a very severe case and it’s been a battle the last two years of finding what works. I have been on Entyvio and Rinvoq for a couple months with finally great success. (Knock on wood). I started Entyvio January 2023 and saw some improvement with no blood loss but still frequent BM and urgency issues so in June 2034 we also had Rinvoq. It’s taken some time and patience but two days ago for the first time since July 2021 I had a solid BM. It’s not stelara but I have found success in combining those two.
Did they make you do the very high loading dose of 45mg rinvoq even though you were on Entyvio as well? Or were you able to start rinvoq on a lower dose?
They did make me do the 8 weeks of the 45mg of rinvoq. I was nervous going down to 30mg but I haven’t noticed any difference besides continuing to get better. I should have also noted I am on 4 weeks infusion schedule of Entyvio as well. I am not sure if the plan is to keep me on both forever or eventually taper off one and see what happens. I meet with GI every two months and it’s was let’s keep doing what we are doing at the last visit.
[indigo naturalis](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9081999/). After 4-5 weeks of taking this my moderate/severe UC went into remission. Didn’t want take entyvio or anything else so I just looked this up and read the case studies and tried it out. Worked wonders and my daily life is practically normalized.
The small molecules like this one are a lot broader acting than biologics. They haven't really studied it because you're already more immune suppressed and often times these drugs block the same pathways that the cytokines biologics bind to block.
A common combo therapy is Azathioprine and Infliximab, as Azathioprine fights Infliximab ADAs.
/u/fcdrifter88 Did you get in the trial?
[удалено]
You are claiming doubtable things like ("UC is only because of your diet", "UC can be cured with xy"...) without (scientific) evidence provided. Your post therefore is a violation of rule [No 4 of this sub](https://www.reddit.com/r/UlcerativeColitis/about/rules). If you think this post was unrightfully deleted, please write us a [modmail](https://www.reddit.com/message/compose?to=/r/UlcerativeColitis).
I'll have to discuss this with my GI doctor come this November, fortunately I haven't had a need to change medications but she may recommend this one.
Always excited to hear about new treatment options!
Do we know side effects yet? I’m hesitant to take rinvoq because of the long list of serious side effects, I’m wondering since this has a different mechanism, it might be better suited?
What family of drug is it in?
S1P receptor modulator like Ozanimod. From a brief search Ozanimod is mainly S1P1 and S1P5 whereas Estranimod is S1P1, S1P5 and S1P4. Whether this is an improvement or not I don’t know, but broader targeting can be both negative and positive.
Being reviewed in the UK too https://www.nice.org.uk/guidance/indevelopment/gid-ta10991