Ozanimod Hydrochloride

-01-引言炎症性肠病（IBD）是一种慢性和复发性炎症疾病，包括克罗恩病（CD）和溃疡性结肠炎（UC）。这些疾病的特点是持续炎症，导致各种并发症，严重影响IBD患者的生活质量。早期有效的治疗对于预防复发和并发症、全面改善IBD患者的健康状况至关重要。目前可用的IBD治疗包括非靶向治疗（如氨基水杨酸、糖皮质激素和免疫调节剂）和靶向治疗（如抗TNF、抗IL-12/IL-23和抗α4β7整合素）。虽然生物靶向疗法对许多患者有效，但依然有高达30%的患者对初始治疗没有反应，高达50%的患者随着时间的推移反应消失。目前，分子生物学领域的最新进展和对IBD免疫途径的理解为创新药物疗法开辟了新的可能性。一些新兴疗法和药物有望打破IBD治疗的瓶颈，为IBD的患者的疾病改善带来福音。-02-IBD的免疫学发病机制IL-22和IL-6IL-22是一种多效性细胞因子，由Th22、Th17和Th1细胞分泌，激活STAT3以促进肠组织修复并抑制肠道病原体。在IBD中，IL-22受微生物群的信号诱导在小肠中广泛表达。此外，IL-22还促进IBD易感基因如fut2、sec1、bcl2115和PTPN22的表达。IL-6主要由固有层中的巨噬细胞和树突状细胞产生。研究发现，CD患者血清和肠道中IL-6水平升高，并与临床疾病活动、复发频率和炎症严重程度相关。与受体结合后，IL-6激活gp130阳性T细胞，导致STAT-3信号转导和转录激活，随后激活抗凋亡基因Bcl-2和Bcl-xl的转录。目前，人源化抗IL-6R单克隆抗体tocilizumab已经用于治疗IBD。IL-12/IL-23由树突状细胞产生的IL-12和IL-23均属于IL-12家族，在慢性炎症性疾病的发病机制中发挥重要作用。在几种结肠炎模型中，致病性T细胞反应由IL-12和IL-23驱动。IL-12可以促进原始CD4+T细胞分化为产生IFN-γ的Th1细胞，并促进NK细胞、NKT细胞和细胞毒性T细胞的增殖和效应功能。IL-23通过加强和影响Th17细胞反应来发挥其生物学功能，同时它还拮抗抗炎Foxp3+Treg细胞反应从而促进肠道炎症。IL-17IL-17细胞因子，包括IL-17A和IL-17F，也在IBD的发病机制中发挥重要作用。全基因组关联研究（GWAS）已确定了许多与Th17相关的IBD易感基因，包括JAK2、STAT3、IL-23R、IL-12B和CCR6。临床研究发现，与健康对照组相比，IBD患者的肠粘膜和固有层中含有更高水平的Th17细胞、IL-17和IL-23。在小鼠模型中，IL-17A和IL-17F的缺陷显示对结肠炎具有保护作用。Il-10IL-10是抑制免疫系统促炎反应的最重要细胞因子，可由大量不同类型的细胞产生，包括Treg、巨噬细胞、树突状细胞等。在IBD患者的早期发病过程中，IL-10R亚单位基因的突变与肠道炎症免疫反应有关。事实上，IL-10和IL-10R缺陷小鼠都可以发生自发性结肠炎。此外，Treg细胞中c-MAF失活也会导致IL-10产生功能障碍，从而发展为自发性结肠炎。IL-1β家族细胞因子IL-1β是一种由巨噬细胞分泌的促炎细胞因子，与其他促炎细胞因子（如TNF-α和IL-6）协同作用，以诱导IBD炎症。研究发现，IL-10缺陷小鼠在自发性结肠炎发病前IL-1β分泌增加。此外，IL-1β和IL-18信号的遗传缺陷或抑制可缓解实验性结肠炎。TNF和TNF样配体1A（TL1A）TNF被认为是IBD发病机制中的促炎细胞因子，可刺激急性期时的反应，促进IL-1和IL-6的分泌，增加粘附分子的表达。研究发现，活动期IBD患者的血液、上皮组织和粪便中TNF-α显著升高，其水平与CD患者的临床疾病活动性相关。通过抗TNF-α单克隆抗体阻断TNF-α信号已成为中重度难治性IBD患者的重要治疗方法。TNF家族成员TL1A也被发现是肠道炎症的关键介质，在IBD患者中水平也升高。TL1A主要通过结合死亡受体3（DR3）发挥其功能，TL1A还可以协同促进IL-4、IL-12和IL-23的产生，并通过Th1、Th2和Th17细胞增加DR3的表达，以促进炎症。免疫细胞迁移免疫细胞迁移到肠道以启动和维持免疫反应是IBD的关键发病机制，其中T细胞迁移是最重要的一个。免疫细胞迁移的完整过程包括栓系、滚动、激活、粘附和外渗，涉及各种整合素、选择素、趋化因子及其配体或受体，例如促进迁移到小肠的整合素α4β7、α4β1、β2整合素和CCR9。针对免疫细胞迁移不同阶段的多种治疗方法已经应用于临床。-03- IL抑制剂IL-23是IL-12细胞因子家族的一员，由p40和p19亚基组成，其中p19是IL-23所特有的。IL-23在调节和扩增辅助T细胞和激活各种先天免疫细胞方面发挥着至关重要的作用，这些细胞在UC和CD等慢性炎症性疾病的发展中很重要。Risankizumab是FDA批准的第一种用于治疗中重度CD患者的选择性IL-23p19抑制性抗体。Brazikumab（MEDI2070）是另一种IL-23p19的人源IgG2单克隆抗体，已在一项针对中重度CD患者的2a期临床试验中进行了评估。结果显示，Brazikumab组在第8周和第24周分别观察到42.3%和23.1%的患者出现持续临床响应和临床缓解，而安慰剂组分别为23.1%和11.5%。报告的最常见AE是头痛和鼻咽炎。目前，一项名为INTREPID的2b/3期研究正在招募中。Guselkumab是一种特异性抑制IL-23p19的人源IgG1单克隆抗体。在一项针对中重度UC患者的2b期临床研究中，低剂量和高剂量的Guselkumab的临床有效率分别为61.4%和60.7%，均显著高于安慰剂（p＜0.001）。Guselkumab和安慰剂的不良事件相似。Mirikizumab这是一种抑制IL-23p19的人源化IgG4单克隆抗体。在两项针对中重度UC患者的3期临床试验（NCT03518086和NCT03524092）中，与安慰剂组相比，mirikizumab组获得临床缓解的患者比例明显更高（分别为24.2% vs 13.3%，p＜0.001和49.9% vs 25.1%，p＞0.001）。IL-36细胞因子是更广泛的IL-1细胞因子家族的成员。在过去的几年里，许多研究强调了IL-36R信号在慢性炎症条件下的作用，包括CD和UC。Spesolimab是一种新型人源化IgG1单克隆抗体，特异性抑制IL-36R信号传导，其已在涉及中重度UC患者的三项2/2a期临床试验中进行了评估，然而，尽管spesolimab对UC患者具有良好的耐受性，但并未达到疗效终点。目前，其正在进行一项2期临床试验，以测试spesolimab在造瘘CD患者中的应用。IL-6参与双重信号传导途径：经典信号传导途径，其需要与免疫和肠道细胞上的膜结合IL-6受体（IL-6R）和gp130结合；以及反式信号转导途径，其中可溶性IL-6/IL-6 R复合物激活单独表达gp130的细胞。其中反式信号通路与慢性炎症有关，抗IL-6药物已显示出对炎症性疾病的潜在益处。Olamkicept（sgp130Fc）是一种选择性靶向IL-6反式信号传导的FC融合蛋白。在一项为期12周，涉及16名IBD患者的开放标签2a期研究中，结果显示: 19%的患者获得了临床缓解，44%的患者出现临床响应。此外，最常报告的不良事件包括季节性上呼吸道感染、唇疱疹复发以及皮肤和皮下疾病。目前，其正在进行一项更大规模的安慰剂对照临床研究（NCT03235752）。-04-TNF抑制剂抗TNF的抗体已广泛使用约25年。目前，四种TNF-α抑制剂已被批准用于临床，包括infliximab、adalimumab、golimumab和certolizumab pegol。infliximab可诱导粘膜溃疡愈合，这是第一种被批准用于CD肛周瘘的治疗方法，并被证明对CD和UC都有效。OPRX-106是一种口服重组靶向TNF的融合蛋白，在2a期开放标签临床试验中进行了测试，该试验涉及25名活动性轻度至中度UC患者。根据Mayo评分，67%和28%的患者出现临床反应和临床缓解。OPRX-106表现出良好的耐受性，未报告严重不良事件。需要进一步的研究来彻底评估这种药物的疗效和安全性。V565是一种新型抗体，特异性靶向TNFα，经改造可耐受肠道蛋白酶的降解。最近结束的一项2期研究（NCT02976129）中，评估了V565在6周内治疗活动性CD患者的有效性。结果显示，治疗组和安慰剂组的临床反应率没有显著差异，V565组为35.4%，安慰剂组为37.2%。然而，治疗组的内镜检查结果改善率更高（56.3% vs 30.0%）。两个队列中严重急性呼吸系统综合征的发生频率相当，没有死亡报告。-05-整合素抑制剂近年来，整合素受体已成为治疗IBD患者新疗法的可行靶点。整合素包括两个亚基，α和β，存在于特定的B和T淋巴细胞上。与细胞迁移到胃肠组织有关的是α2β2、α4β1和α4β7。通过拮抗这些受体，淋巴细胞在炎症过程中迁移到胃肠道粘膜受到抑制。抗α4β7整合素抗体Vedolizumab已于2020年获得欧洲药品管理局（EMA）的批准，用于治疗中重度UC或CD的成年患者。Abrilumab是一种阻断α4β7整合素的单克隆抗体。在一项针对中重度UC患者的2b期临床研究中，相比于安慰机组的4%，Abrilumab治疗组的患者中，低剂量和高剂量分别获得了13%和12%的临床缓解，达到了试验的主要终点。此外，与安慰剂相比，这些剂量的临床反应和粘膜愈合率显著更高。AJM-300是一种小分子α4-整合素拮抗剂，口服给药。在一项针对活跃性UC患者的2a期临床试验中，结果显示：与安慰剂组相比，接受AJM-300治疗的患者在第9周的临床响应率和缓解率显著较高（分别为62.7% vs 23.5%，25.5% vs 3.9%）。AJM-300给药期间未观察到严重不良事件。AJM-300耐受性良好，在中度活动性UC患者中诱导临床反应方面优于安慰剂。Ontamalimab（PF-00547659）是一种人IgG2抗MAdCAM-1单克隆抗体，可特异性阻碍α4β7整合素与人粘膜地址素粘附分子-1（MAdCAM1）配体的结合，从而减少淋巴细胞向肠道的迁移。在一项针对中重度UC患者的临床试验（TURANDOT）中，结果显示：与安慰剂组相比，治疗组在第12周的缓解率显著较高。此外，ontamalimab表现出良好的耐受性和良好的安全性。-06-SP1R调节剂鞘氨醇-1磷酸（S1P）是一种来源于细胞膜的高度生物活性分子，主要通过激活细胞表面的五个G蛋白偶联受体发挥作用（S1P1-S1P5）。激活后，该过程触发一系列信号事件，控制广泛的生物学过程，如淋巴细胞迁移、内皮细胞通透性、血管生成以及细胞分化、增殖、存活和凋亡。S1P通路与胃肠道炎症相关的疾病有关。Ozanimod是S1P受体的选择性调节剂，特异性靶向S1P1和S1P5受体，这两种受体分别存在于内皮细胞和少突胶质细胞上。在一项3期针对中重度UC患者的临床研究（TRUE NORTH）中，结果显示：相比与安慰剂组，Ozanimod组获得了更多的临床缓解（18.4% vs 6.0%  p=0.001），此外，在诱导治疗的应答者中，37.0%的患者在52周后持续临床缓解，而安慰剂组为18.5%（p＜0.001）。Ozanimod最常见的AE是肝转氨酶水平升高和淋巴细胞减少。Etrasimod是S1P1、S1P4和S1P5受体的选择性口服激动剂。最近，进行了两项针对中重度活动性UC患者的3期临床试验（ELEVATE UC12和ELEVATE UC52）。结果显示：在ELEVATE UC 12试验中，与安慰剂组相比，etrasimod组在12周诱导期结束时的临床缓解率更高（25% vs 15%，p=0.026）。ELEVATE UC52试验中，在第12周和第52周，与安慰剂组相比，etrasimod组获得临床缓解的患者比例明显更高（分别为27% vs 7%，p<0.0001和32% vs 7%，p<0.0001）。在两项临床试验中均观察到该分子具有良好的安全性。CBP-307是一种口服小分子，设计用于靶向S1P1受体。在一项涉及145名中重度UC患者的2期临床研究中，结果显示：与安慰剂组相比，CBP-307获得临床缓解的患者比例更高（28.3% vs 9.6%，p=0.016）。安全性结果表明，CBP-307总体耐受性良好。基于这些发现，CBP-307在UC中的进一步临床开发正在进行中。KRP203是S1P1受体的强效口服激动剂。在一项针对中度UC患者的2期临床研究中， KRP203组14%的患者获得了临床缓解，而安慰剂组为0%。最常见的AE是胃肠道疾病和头痛，治疗组之间的发生率相似。尽管该研究没有达到最低临床相关疗效阈值，但结果表明，KRP203治疗可能比安慰剂更有效，有必要进行进一步研究。Amiselimod是一种口服选择性S1P1受体调节剂，在一项针对中重度CD患者的2a期临床研究中进行了评估。在纳入研究的180名患者中，与安慰剂组相比，在第12周达到临床反应的主要终点没有显示出显著差异（48.7% vs 54.1%）。-07-JAK抑制剂近年来，有许多研究聚焦于JAK-STAT途径，为改善IBD的治疗提供了新的治疗策略。JAK是一个细胞内酪氨酸激酶家族，包括JAK1、JAK2、JAK3和酪氨酸激酶2（TYK2），在通过STAT途径传递细胞因子介导的信号中发挥作用。这些激酶被各种细胞因子受体激活，通过T细胞增殖和分化以及B细胞活化导致炎症。Izencitinib是一种泛JAK抑制剂，其在一项涉及239名UC患者的2b期临床试验中进行了测试。与安慰剂相比，临床缓解的主要次要终点均未实现。此外，Izencitinib在所有给药剂量中均表现出良好的耐受性。在CD方面，进行一项针对中重度CD患者的2期研究，Izencitinib耐受性良好；然而，在治疗12周后，没有观察到CDAI或内窥镜严重程度的统计学显著降低。Ivarmacidinib（SHR0302）是一种选择性JAK1抑制剂，在涉及146名中重度活动性UC患者的一项2期临床研究中，与安慰剂相比，8 mg每日一次和4 mg每日两次给药方案在第8周显示出显著更高的临床响应率和临床缓解率，不良事件没有显著差异。这些有希望的结果导致其启动了一项3期研究，以进一步研究对UC的疗效。Peficitinib是一种口服泛JAK抑制剂，在一项针对中重度UC患者的2b期临床研究中，与安慰剂相比，每天接受Peficitinib≥75 mg或以上治疗的患者获得了显著的临床反应、缓解和粘膜愈合。此外，接受Peficitinib治疗的患者和接受安慰剂治疗的患者的AE平均发生率相似（45.5%对34.9%）。Ritlecitinib和Brepocitinib这两种口服JAK抑制剂分别是JAK3和TYK2/JAK1抑制剂。最近，在一项为期32周针对活动期UC患者的2b期临床研究中（VIBRATO）进行了探索。结果显示，两种JAK抑制剂都导致了剂量-效应关系，并且在第8周时，Ritlecitinib 70和200 mg组以及Brepocitinib 30和60 mg组的临床缓解率显著更高。最常见的不良事件是贫血、头痛和咽炎。Deucravacitinib是一种TYK2抑制剂，通过IL-12和IL-23调节炎症信号，最近在一项2期研究（LATTICE-UC）中对中重度活动性UC进行了测试。然而在第12周，治疗组和安慰剂组的临床缓解率和内镜反应率没有统计学差异。第二项2期试验将评估UC患者服用更高剂量的Deucravacitinib。OST-122是一种AK3/TYK2/ARK5的选择性抑制剂，是UC、CD和与CD相关的潜在纤维化病变的治疗选择。目前，一项正在进行的涉及32名中重度UC患者的1b/2a期研究正在进行中。-08-TL1AR抑制剂TNFSF15，也称为TNF样配体1A（TL1A），由抗原呈递细胞分泌，并通过激活T细胞参与导致慢性炎症的促炎作用。TL1A在UC患者结肠粘膜中上调，其水平与疾病严重程度有关。此外，TL1A在CD患者的组织中也高表达，并与促纤维化和严重疾病有关。因此，TL1A抑制可能是炎症性疾病的治疗靶点。PF-06480605是一种抗TL1A的IgG1人源单克隆抗体，在一项针对中重度UC患者的2a期临床研究（TUSCANY）中，有一部分（38.2%）患者在第14周获得了内窥镜改善，这一比例具有统计学意义。此外，最常见的AE是UC疾病恶化和关节痛。组织病理学分析支持PF-06480605进一步的研究。PRA-023是一种靶向TL1A的人源化单克隆抗体，在最近的一项针对中重度CD患者的2a期临床研究中进行了评估。结果显示，与安慰剂相比，在第12周，接受PRA023治疗的患者获得临床缓解和内镜改善的比例明显更高（分别为26.5% vs 1.5%，p<0.0001和36.8% vs 6.0%，p>0.0001），未报告严重不良事件。-09-PDE抑制剂环核苷酸磷酸二酯酶（PDEs）是催化cAMP和/或cGMP水解的一大类酶。尤其是PDE4在树突状细胞、巨噬细胞、单核细胞和T细胞中表达，被认为是炎症反应中的重要参与者。PDE4间接增强NF-κB的激活，促进促炎介质如TNF-a、IL-23、IL-17和IFN-γ的产生，并降低抗炎细胞因子如IL-10的表达。因此，PD4抑制剂可能通过在多个水平上发挥作用成为IBD的治疗靶点。Apremilast是一种口服小分子PDE4抑制剂，通过抑制TNF-a和基质金属蛋白酶3（MMP-3）在细胞内发挥作用。在一项针对活动性UC患者的2期临床试验中，与安慰剂相比，接受Apremilast治疗的患者中，有更高比例的患者在临床特征和炎症标志物方面有所改善。具体而言，30 mg组31.6%的患者和40 mg组21.8%的患者实现了临床缓解，而安慰剂组为12.1%。最常见的不良事件是头痛和恶心。-10-TLR9激动剂Toll样受体（TLRs）激活固有免疫保护宿主免受外部微生物入侵。TLR9是TLR家族的一员，被细菌或病毒来源的CpG-DNA激活。TLR9在结肠炎发病机制中的作用已在小鼠实验模型中进行了研究。有趣的是，与野生型对照相比，TLR9缺陷小鼠具有更严重的结肠炎表型。TLR9激动剂治疗后，结肠炎的严重程度显著降低。因此，TLR9激动剂可能在IBD治疗中发挥关键作用。Cobitolimod（DIMS0150）是一种合成的ODN，含有未甲基化的CpG基序，并激活特定细胞中的TLR9，包括肠道T和B淋巴细胞以及抗原呈递细胞（APC）。最近，其在一项针对中重度UC患者的2b期临床研究（CONDUCT）中进行了测试。结果显示，在第6周，与安慰剂组相比，接受cobitolimod获得临床缓解的患者比例显著更高（21% vs 7%）。Cobitolimod有望成为UC患者的一种新的独特治疗方法，目前正在进行大规模的3期临床试验（NCT04985968）。-11-miRNA调节剂miRNA已被证明在不同的生物过程中作为基因表达的调节剂发挥着至关重要的作用，如免疫系统的发育以及先天和适应性免疫反应的调节。一些研究表明，miRNA可以调节肠上皮紧密连接通透性、肠IL-12/IL-23p40表达、Th-17细胞分化和炎症细胞运输，可能参与UC的发病机制。Obefazimod （ABX464）是一种喹啉，选择性上调免疫细胞中的miR-124，并逆转炎症过程中触发的几种炎症细胞因子的表达。这种小分子已在针对中重度UC患者的2a期和2b期临床研究中进行了测试。结果显示，在第8周，与安慰剂组相比，ABX464组表现出更高的临床缓解率（70% vs 33%）和临床反应率（35% vs 11%）。ABX464治疗12个月后，75%的可评估内镜患者获得临床缓解，33.3%的患者保持持续缓解，66.7%的患者在延长期获得临床缓解。ABX464组78%的患者报告了AE，其中腹痛和头痛最为常见。-12-IP-10抑制剂INF-γ诱导蛋白-10（IP-10），也称为CXCL10，是一种趋化因子，通过与趋化因子受体3（CXCR3）的相互作用在促炎途径的激活中发挥重要作用。BMS-936557是一种靶向IP-10的全人源单克隆抗体，在最近的一项针对中重度UC患者的2期临床研究中进行了评估。结果显示，BMS-936557总体安全且耐受性良好，但未达到主要和次要终点。后续分析表明，较高的BMS-936557浓度与增强的临床反应有关，需要进一步的剂量反应研究来评估抗体的疗效。-13-结语在过去的几十年里，IBD的免疫学机制取得了很大进展，为IBD的治疗提供了新的策略和新的思路。在未来，特定基因位点的改变可能是IBD很有希望的治疗方法。此外，新型抗体或抑制剂、联合治疗方案和多因子阻断剂也有望打破IBD治疗的瓶颈。然而，挑战依然存在，因为并非所有研究都达到了其主要终点。对于大多数药物来说，设计良好、大规模、受控的3期临床试验仍然是必要的。参考资料：1.Immunology of Inflammatory Bowel Disease: Molecular Mechanisms and Therapeutics. J Inflamm Res.2022; 15: 1825–1844.2. Inflammatory Bowel Disease: Emerging Therapies and Future Treatment Strategies. Biomedicines.2023 Aug; 11(8): 2249.公众号内回复“ADC”或扫描下方图片中的二维码免费下载《抗体偶联药物：从基础到临床》的PDF格式电子书！公众号已建立“小药说药专业交流群”微信行业交流群以及读者交流群，扫描下方小编二维码加入，入行业群请主动告知姓名、工作单位和职务。

TREMFYA® subcutaneous induction demonstrates significant rates of clinical remission and endoscopic improvement at Week 24 in ulcerative colitis Findings build on recent FDA-approval of both routes of administration for induction therapy with TREMFYA® in Crohn's disease SAN DIEGO, May 5, 2025 /PRNewswire/ -- Johnson & Johnson (NYSE: JNJ) today announced new data from the Phase 3 ASTRO study evaluating TREMFYA® (guselkumab) subcutaneous (SC) induction therapy in adults with moderately to severely active ulcerative colitis (UC). The ASTRO Week 24 data build on the Week 12 SC induction data that showed statistically significant and clinically meaningful improvements compared to placebo across all clinical and endoscopic measures consistent with the U.S. Food and Drug Administration (FDA)-approved intravenous (IV) induction regimen evaluated in this population, in the Phase 3 QUASAR study.1,2 TREMFYA® is the first and only IL-23 inhibitor to demonstrate robust results with a fully SC regimen. These findings are among 24 abstracts highlighting the Company's research being presented at Digestive Disease Week (DDW) 2025. Data at Week 24 show patients treated with TREMFYA® 400 mg SC induction followed by SC maintenance dose regimens of either 100 mg every eight weeks (q8w) or 200 mg every four weeks (q4w) demonstrated statistically significant and clinically meaningful improvements across all clinical and endoscopic measures compared with patients receiving placebo.1 "Data from the ASTRO study demonstrate that subcutaneous induction treatment with TREMFYA provides clinically meaningful remission in patients with ulcerative colitis, similar to the effects seen with intravenous induction," said Millie Long, M.D., MPH, Professor of Gastroenterology and Hepatology at the University of North Carolina at Chapel Hill and study investigator.e "The availability of both subcutaneous and intravenous induction options would offer physicians and patients greater flexibility in their treatment approach." Furthermore, at Week 24, in prespecified analyses of subpopulations defined by prior advanced therapy treatment status, TREMFYA® demonstrated statistically significant results across endpoints in both biologic and JAK inhibitor-naïve and biologic and JAK inhibitor-refractory patients. Safety data from the ASTRO study were consistent with the well-established safety profile of TREMFYA®.1 "These results highlight the potential of TREMFYA to redefine ulcerative colitis care with a fully subcutaneous induction and maintenance regimen that offers a convenient option with meaningful clinical and endoscopic improvements," said Esi Lamousé-Smith, MD, PhD, Vice President, Gastroenterology Disease Area Lead, Immunology, Johnson & Johnson Innovative Medicine. "Our goal is to reshape UC care and empower prescribers with a differentiated and effective treatment that offers the option of patient self-administration from day one." TREMFYA® is the first and only approved, dual-acting monoclonal antibody that blocks IL-23 while also binding to CD64, a receptor on cells that produce IL-23. IL-23 is a cytokine secreted by activated monocyte/macrophages and dendritic cells that is known to be a driver of immune-mediated diseases including UC.3,4,5,6,7 TREMFYA® received FDA approval in September 2024 for the treatment of adult patients with moderately to severely active UC and is currently administered via an IV induction regimen, followed by a SC maintenance regimen. In November 2024, a supplemental Biologics License Application (sBLA) was submitted to the FDA seeking approval of a SC induction regimen of TREMFYA® for the treatment of adults with moderately to severely active UC. TREMFYA® was also approved by the FDA in March 2025 for SC and IV induction options for the treatment of adults with moderately to severely active Crohn's disease (CD). For a full list of all data being presented at DDW visit: Editor's Notes: a. Clinical remission was defined as a Mayo stool frequency subscore of 0 or 1 and not increased from baseline, a Mayo rectal bleeding subscore of 0, and a Mayo endoscopic subscore of 0, or 1 with no friability present on the endoscopy. b. Symptomatic remission per Mayo score is defined as a stool frequency subscore of 0 (normal number of stools) or 1 (1 to 2 stools more than normal) and a rectal bleeding subscore of 0 (no blood seen). c. Endoscopic improvement was defined as an endoscopy subscore of 0 or 1 with no friability present on the endoscopy. d. Clinical response is defined as decrease from baseline in the modified Mayo score by greater than or equal to (>=) 30 percent (%) and >=2 points, with either a >=1-point decrease from baseline in the rectal bleeding subscore or a rectal bleeding subscore of 0 or 1. e. Dr. Long is a paid consultant for Johnson & Johnson. She has not been compensated for any media work. ABOUT THE ASTRO STUDY (NCT05528510) ASTRO is a randomized, double-blind, placebo-controlled, parallel-group, multicenter, treat-through Phase 3 study designed to evaluate the efficacy and safety of TREMFYA® SC induction therapy (400 mg at Weeks 0, 4, and 8) in adults with moderately to severely active ulcerative colitis who had an inadequate response or intolerance to conventional therapy (e.g., thiopurines or corticosteroids), prior biologics (TNF antagonists or vedolizumab) and/or ozanimod or approved JAK inhibitors. Patients (n = 418) were randomized 1:1:1 to receive TREMFYA® 400 mg SC induction at Weeks 0, 4 and 8 followed by TREMFYA® 200 mg SC every 4 weeks (q4w); or TREMFYA® 400 mg SC induction at Weeks 0, 4 and 8, followed by TREMFYA® 100 mg SC every 8 weeks (q8w); or placebo. The maintenance dose regimens in ASTRO (200 mg SC q4w and 100 mg SC q8w) are the same as those evaluated in the Phase 3 QUASAR program which established the efficacy and safety profile of IV induction followed by SC maintenance therapy in patients with moderate to severely active UC.8 ABOUT ULCERATIVE COLITIS Ulcerative colitis (UC) is a chronic disease of the large intestine, also known as the colon, in which the lining of the colon becomes inflamed and develops tiny open sores, or ulcers, that produce pus and mucus. It is the result of the immune system's overactive response. Symptoms vary but may typically include loose and more urgent bowel movements, rectal bleeding or bloody stool, persistent diarrhea, abdominal pain, loss of appetite, weight loss, and fatigue.9 ABOUT TREMFYA® (guselkumab) Developed by Johnson & Johnson, TREMFYA® is the first approved fully-human, dual-acting monoclonal antibody designed to neutralize inflammation at the cellular source by blocking IL-23 and binding to CD64 (a receptor on cells that produce IL-23). Findings for dual-acting are limited to in vitro studies that demonstrate guselkumab binds to CD64, which is expressed on the surface of IL-23 producing cells in an inflammatory monocyte model. The clinical significance of this finding is not known. TREMFYA® is a prescription medicine approved in the U.S. to treat: adults with moderate to severe plaque psoriasis who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet or UV light). adults with active psoriatic arthritis. adults with moderately to severely active ulcerative colitis. adults with moderately to severely active Crohn's disease.5 TREMFYA® is approved in Europe, Canada, Japan, and a number of other countries for the treatment of adults with moderate-to-severe plaque psoriasis and for the treatment of adults with active psoriatic arthritis. In addition, TREMFYA ® is approved in Europe, Japan and Brazil for the treatment of adult patients with moderately to severely active UC and in Brazil and China for the treatment of adults with moderately to severely active CD. Johnson & Johnson maintains exclusive worldwide marketing rights to TREMFYA®. For more information, visit: . IMPORTANT SAFETY INFORMATION What is the most important information I should know about TREMFYA®? TREMFYA® is a prescription medicine that may cause serious side effects, including: Serious Allergic Reactions. Stop using TREMFYA® and get emergency medical help right away if you develop any of the following symptoms of a serious allergic reaction: Infections. TREMFYA® may lower the ability of your immune system to fight infections and may increase your risk of infections. Your healthcare provider should check you for infections and tuberculosis (TB) before starting treatment with TREMFYA® and may treat you for TB before you begin treatment with TREMFYA® if you have a history of TB or have active TB. Your healthcare provider should watch you closely for signs and symptoms of TB during and after treatment with TREMFYA®. Tell your healthcare provider right away if you have an infection or have symptoms of an infection, including: Liver problems. With the treatment of Crohn's disease or ulcerative colitis, your healthcare provider will do blood tests to check your liver before and during treatment with TREMFYA®. Your healthcare provider may stop treatment with TREMFYA® if you develop liver problems. Tell your healthcare provider right away if you notice any of the following symptoms: Do not use TREMFYA® if you have had a serious allergic reaction to guselkumab or any of the ingredients in TREMFYA®. Before using TREMFYA®, tell your healthcare provider about all of your medical conditions, including if you: have any of the conditions or symptoms listed in the section "What is the most important information I should know about TREMFYA®?" have an infection that does not go away or that keeps coming back. have TB or have been in close contact with someone with TB. have recently received or are scheduled to receive an immunization (vaccine). You should avoid receiving live vaccines during treatment with TREMFYA®. are pregnant or plan to become pregnant. It is not known if TREMFYA® can harm your unborn baby. Pregnancy Registry: If you become pregnant during treatment with TREMFYA®, talk to your healthcare provider about registering in the pregnancy exposure registry for TREMFYA®. You can enroll by visiting , by calling 1-877-311-8972, or emailing [email protected]. The purpose of this registry is to collect information about the safety of TREMFYA® during pregnancy. are breastfeeding or plan to breastfeed. It is not known if TREMFYA® passes into your breast milk. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. What are the possible side effects of TREMFYA®? TREMFYA® may cause serious side effects. See "What is the most important information I should know about TREMFYA®?" The most common side effects of TREMFYA® include: respiratory tract infections, headache, injection site reactions, joint pain (arthralgia), diarrhea, stomach flu (gastroenteritis), fungal skin infections, herpes simplex infections, stomach pain, and bronchitis. These are not all the possible side effects of TREMFYA®. Call your doctor for medical advice about side effects. Use TREMFYA® exactly as your healthcare provider tells you to use it. Please read the full Prescribing Information, including Medication Guide, for TREMFYA® and discuss any questions that you have with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit , or call 1-800-FDA-1088. Dosage Forms and Strengths: TREMFYA® is available as 100 mg/mL and 200 mg/2mL for subcutaneous injection and as a 200 mg/20 mL (10 mg/mL) single dose vial for intravenous infusion. ABOUT JOHNSON & JOHNSON At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a world where complex diseases are prevented, treated, and cured, where treatments are smarter and less invasive, and solutions are personal. Through our expertise in Innovative Medicine and MedTech, we are uniquely positioned to innovate across the full spectrum of healthcare solutions today to deliver the breakthroughs of tomorrow, and profoundly impact health for humanity.   Learn more at or at Follow us at @JNJInnovMed. Janssen Research & Development, LLC and Janssen Biotech, Inc. are Johnson & Johnson companies.  Cautions Concerning Forward-Looking Statements This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995 regarding TREMFYA®. The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of Johnson & Johnson. Risks and uncertainties include, but are not limited to: challenges and uncertainties inherent in product research and development, including the uncertainty of clinical success and of obtaining regulatory approvals; uncertainty of commercial success; manufacturing difficulties and delays; competition, including technological advances, new products and patents attained by competitors; challenges to patents; product efficacy or safety concerns resulting in product recalls or regulatory action; changes in behavior and spending patterns of purchasers of health care products and services; changes to applicable laws and regulations, including global health care reforms; and trends toward health care cost containment. A further list and descriptions of these risks, uncertainties and other factors can be found in Johnson & Johnson's most recent Annual Report on Form 10-K, including in the sections captioned "Cautionary Note Regarding Forward-Looking Statements" and "Item 1A. Risk Factors," and in Johnson & Johnson's subsequent Quarterly Reports on Form 10-Q and other filings with the Securities and Exchange Commission. Copies of these filings are available online at , or on request from Johnson & Johnson. Johnson & Johnson does not undertake to update any forward-looking statement as a result of new information or future events or developments. References: 1 Peyrin-Biroulet, et al. Efficacy and safety of subcutaneous guselkumab induction therapy in patients with Ulcerative Colitis: Results through week 12 from the phase 3 ASTRO study. Results from the Phase 3 ASTRO study. Oral presentation (#OP10) at the 20th Congress of the European Crohn's and Colitis Organization (ECCO). February 2025. 2 Long M, et al. Efficacy And Safety Of Subcutaneous Guselkumab Induction Therapy In Patients With Ulcerative Colitis: Results Through Week 24 From The Phase 3 Astro Study. Oral presentation (#4241895) at Digestive Disease Week 2025. May 2025. 3 Atreya R, Abreu MT, Krueger JG, et al. Guselkumab, an IL-23p19 subunit-specific monoclonal antibody, binds CD64+ myeloid cells and potentially neutralizes IL-23 produced from the same cells. Poster presented at: 18th Congress of the European Crohn's and Colitis Organization (ECCO); March 1-4, 2023; Copenhagen, Denmark. Poster P504. 4 Kreuger JG, Eyerich K, Kuchroo VK. Il-23 past, present, and future: a roadmap to advancing IL-23 science and therapy. Front Immunol. 2024; 15:1331217. doi:10.3389/fimmu.2024.1331217. 5 TREMFYA® [Prescribing Information]. Horsham, PA: Janssen Biotech, Inc. 6 Skyrizi® [Prescribing Information]. North Chicago, IL: AbbVie, Inc. 7 Omvoh™ [Prescribing Information]. Indianapolis, IN: Eli Lilly and Company. 8 National Institutes of Health: Clinicaltrials.gov. A Study of Guselkumab Therapy in Participants With Moderately to Severely Active Ulcerative Colitis (ASTRO). Identifier: NCT05528510. . Accessed March 2025. 9 Crohn's & Colitis Foundation. What is ulcerative colitis? Available at: . Accessed March 2025 SOURCE Johnson & Johnson WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED