A Randomised Double-Blind Placebo-Controlled Phase III Clinical Study to Evaluate the Efficacy and Safety of Cobitolimod as an Induction and Maintenance Therapy in Participants With Moderate to Severe Active Left-Sided Ulcerative Colitis

The purpose of the study is to evaluate the efficacy of cobitolimod treatment compared to placebo in inducing clinical remission, in participants with moderate to severe active left-sided UC and to evaluate the efficacy of cobitolimod maintenance treatment compared to placebo in inducing or maintaining clinical remission at week 52, in participants with clinical response at week 6 after induction treatment with cobitolimod.

开始日期2021-11-24

申办/合作机构

Flerie AB

NCT05404074

/ Recruiting临床1期

Pharmacokinetics of Cobitolimod Enemas in Participants With Active Ulcerative Colitis

The purpose of the study is to evaluate the PK, safety and tolerability of cobitolimod ememas (500mg/50mL) given to participants with active left-sided UC.

开始日期2021-11-22

申办/合作机构

Flerie AB

NCT03178669

/ Completed临床2期

A Randomised Dose-Optimisation Study to Evaluate the Efficacy and Safety of Cobitolimod in Moderate to Severe Active Ulcerative Colitis Patients

The purpose of this study was to evaluate efficacy of cobitolimod treatment at different dose levels and frequencies compared to placebo in patients with moderate to severe left-sided ulcerative colitis.

开始日期2017-06-21

申办/合作机构

Flerie AB

100 项与 Cobitolimod 相关的临床结果

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100 项与 Cobitolimod 相关的转化医学

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100 项与 Cobitolimod 相关的专利（医药）

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项与 Cobitolimod 相关的文献（医药）

2025-06-01·Pharmacology Research & Perspectives

Comparative Efficacy of Different Targeted Therapies in Patients With Moderate‐to‐Severe Ulcerative Colitis: Systematic Review/Network Meta‐Analysis and Mechanistic Overview

Review

作者: Xu, Li ; Sun, Yingzhe ; Hu, Suying ; Hu, Fang ; Pan, Pingting ; Dai, Youran ; Yang, Wenhui ; Li, Qiushuang ; Liu, Shan

ABSTRACT:

Ongoing evaluations of targeted therapies for moderate‐to‐severe ulcerative colitis (UC) continue to unfold, with the emergence of novel drugs. However, head‐to‐head trials comparing these therapies are still lacking. The aim of this study is to investigate the therapeutic effects of targeted therapies in moderate‐to‐severe UC. The Cochrane Library, Web of Science, PubMed, and Embase were searched from the inception to November 12, 2024. Statistical analyses included multivariate random effects models and Bayesian modeling. Stratified and sensitivity analyses were also performed. Publication bias was assessed using funnel plots. Outcomes such as clinical response/remission, endoscopic remission, mucosal healing, quality of life, adverse events (AEs), and serious adverse events (SAEs) were used to quantify the relative therapeutic effects. Thirty‐three studies (33 reported on the induction phase; 13 reported on the maintenance phase) were identified. In the induction phase, Upadacitinib 45 mg demonstrated the highest efficacy in achieving clinical remission (OR 10.03; 95% CI, 4.83–20.80), clinical response (OR 7.96; 95% CI, 3.89–16.28), and mucosal healing rate (OR 8.91; 95% CI, 3.36–23.62). Cobitolimod 250 mg was the first‐ranked treatment (SUCRA, 92.67%) in Endoscopic remission. Vedolizumab 108 mg was the best dosage in reducing Adverse Events (AEs). The optimal dosage for reducing Serious Adverse Events (SAEs) was found to be Tulisokibart 1000/500 mg. During the maintenance phase, Etrasimod 2 mg/kg ranked first in clinical remission (OR 9.58; 95% CI, 2.82–32.59), and Upadacitinib 45 mg was superior in endoscopic remission. Additionally, the most effective medication for raising quality of life was Guselkumab 200 mg (OR 3.04; 95% CI, 1.70–5.40). Consequently, there is a need for further high‐quality research to conclusively determine the best therapeutic option.

2022-04-01·Alimentary pharmacology & therapeutics1区 · 医学

Review article: emerging drug therapies in inflammatory bowel disease

1区 · 医学

Review

作者: Grossberg, Laurie B. ; Papamichael, Konstantinos ; Cheifetz, Adam S.

Summary:

Background:

The landscape of inflammatory bowel disease (IBD) treatment is rapidly expanding with the development of new therapeutic options.

Aim:

To review the mechanisms of action and the available clinical trial data on emerging drug therapies for IBD.

Methods:

Pubmed, Medline and Cochrane databases were queried up to July 2021 using keywords “inflammatory bowel disease,” “IBD,” “Crohn’s disease,” “ulcerative colitis” and “trial,” “phase” and “study.” In addition, we manually reviewed the grey literature including clinical trial registries and abstracts from major gastroenterology conferences in 2020 and 2021 to include pertinent information.

Results:

In ulcerative colitis (UC), phase 2b and/or phase 3 studies met primary endpoints for S1P receptor agonists (estrasimod, ozanimod), anti‐IL‐23 agent (mirikizumab), anti‐lymphocyte trafficking agents (ontamalimab, subcutaneous vedolizumab), JAK inhibitors (upadacitinib, filgotinib) and TLR9 agonist (cobitolimod). In Crohn’s disease (CD), anti‐IL‐23 agents (risankizumab, mirikizumab, guselkumab), JAK inhibitors (upadacitinib, filgotinib) and anti‐lymphocyte trafficking agents (ontamalimab, etrolizumab) met primary endpoints in randomised controlled clinical trials.

Conclusion:

Several new IBD drug therapies have positive efficacy and safety data in early clinical trials, and there are several drugs in the therapeutic pipeline. As more treatments for CD and UC are approved for clinical use, research to assess predictors of response to therapy and head‐to‐head trials is needed to inform providers on how to best position therapeutic options for patients with IBD.

2020-12-01·The lancet. Gastroenterology & hepatology1区 · 医学

Cobitolimod for moderate-to-severe, left-sided ulcerative colitis (CONDUCT): a phase 2b randomised, double-blind, placebo-controlled, dose-ranging induction trial

1区 · 医学

Article

作者: Raja Atreya ; Laurent Peyrin-Biroulet ; Karin Arnesson ; Antonio Gasbarrini ; Monica Augustyn ; Andrii Klymenko ; Jan Kowalski ; Igor Bakulin ; William J Sandborn ; Dusan Slankamenac ; Pal Miheller ; Xavier Hébuterne ; Markus F Neurath ; Walter Reinisch ; Thomas Knittel

BACKGROUND:

Cobitolimod is a topically administered, DNA-based oligonucleotide that activates Toll-like receptor 9 (TLR9), and previous research has shown clinical efficacy in patients with moderate-to-severe ulcerative colitis. Here we assessed the efficacy and safety of different dose regimens of cobitolimod for induction therapy in patients with moderate-to-severe, left-sided ulcerative colitis.

METHODS:

CONDUCT was a randomised, double-blind, five-arm, placebo-controlled, dose-ranging phase 2b study that recruited patients with moderate-to-severe, left-sided ulcerative colitis, with inadequate response to conventional or biological therapies, from 91 hospitals or outpatient clinics in 12 European countries. Eligible patients had a Mayo score of 6-12 with a centrally read endoscopic subscore (modified to exclude friability from grade 1) of 2 or higher and no individual subscore of less than 1, and confirmation of left-sided disease. Patients were randomised (1:1:1:1:1; block size of ten) via a computer-generated schedule and centralised interactive voice and web response system to receive rectal enemas of cobitolimod at 31 mg, 125 mg, or 250 mg at weeks 0 and 3 (2 × 31 mg, 2 × 125 mg, and 2 × 250 mg groups), cobitolimod at 125 mg at weeks 0, 1, 2, and 3 (4 × 125 mg group), or placebo. Randomisation was stratified by current glucocorticosteroid and previous tumour necrosis factor inhibitor treatment. Patients and all study personnel were masked to treatment allocation. The primary endpoint was the proportion of patients achieving clinical remission (Mayo subscores for rectal bleeding of 0, for stool frequency of 0 or 1 [with ≥1-point decrease from baseline], and for endoscopy of 0 or 1 [excluding friability]) at week 6. The primary analysis (based on intention to treat) and safety analysis were done in all randomly assigned patients who received at least one dose of active study drug or placebo. In this exploratory study, statistical tests were one-sided; p values of less than 0·10 were regarded as statistically significant, with no adjustment for multiplicity. This study is registered with ClinicalTrials.gov, NCT03178669, and is completed; the results here represent the final analysis.

FINDINGS:

213 patients were randomly assigned between June 30, 2017, and June 26, 2019. Of these, 211 patients received study treatment: 40 in the cobitolimod 2 × 31 mg group, 43 in the 2 × 125 mg group, 42 in the 4 × 125 mg group, 42 in the 2 × 250 mg group, and 44 in the placebo group. A greater proportion of patients were in clinical remission at week 6 in the cobitolimod 2 × 250 mg group than in the placebo group (nine [21%] of 42 patients vs three [7%] of 44; odds ratio [OR] 3·8 [80% CI 1·5-9·5]; one-sided p=0·025). We identified no significant difference in the proportion of patients with clinical remission in the cobitolimod 2 × 31 mg group (five [13%] of 40 patients; OR 2·0 [80% CI 0·7-5·5], p=0·18), 2 × 125 mg group (two [5%] of 43; 0·7 [0·2-2·2], p=0·66), or 4 × 125 mg (four [10%] of 42; 1·4 [0·5-3·9], p=0·33) compared with the placebo group. Treatment-emergent adverse events occurred in 21 (48%) patients in the placebo group, ten (25%) patients in the cobitolimod 2 × 31 mg group, 17 (40%) patients in the 2 × 125 mg group, 15 (36%) patients in the 4 × 125 mg group, and 18 (43%) patients in the 2 × 250 mg group. Severe adverse events occurred in eight (4%) of 211 patients (worsening of ulcerative colitis [seven patients] and abdominal hernia and wound dehiscence [one patient]). Ten patients (two [5%] in the placebo group, two [5%] in the cobitolimod 2 × 31 mg group, two [5%] in the 4 × 125 mg, and four [10%] in the 2 × 250 mg group) had a total of 13 serious adverse events; these were worsening of ulcerative colitis (eight events) and pruritus, rash, abdominal hernia, fascia dehiscence, and deep vein thrombosis (one event each). One patient in the placebo group died from total organ failure after receiving a colectomy for a serious adverse event of disease worsening.

INTERPRETATION:

Two topical administrations of cobitolimod 250 mg were well tolerated and more effective than placebo in inducing clinical remission 6 weeks after the start of treatment. TLR9 activation is a promising novel therapeutic target in ulcerative colitis and warrants further testing, with phase 3 trials of cobitolimod planned.

FUNDING:

InDex Pharmaceuticals.

项与 Cobitolimod 相关的新闻（医药）

2025-06-03

·小药说药

炎症性肠病(IBD)的在研药物

-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。

临床申请细胞疗法临床研究免疫疗法

2024-01-19

·PRNewswire

InDex Pharmaceuticals announces expected cash balance per March 31, 2024

STOCKHOLM, Jan. 19, 2024 /PRNewswire/ -- InDex Pharmaceuticals Holding AB (publ) ("InDex Pharmaceuticals") today announced that remaining commitments for the company have been quantified, and the expected cash balance per March 31, 2024, amounts to SEK 180-190 million. The amount includes all closing costs for the phase III program CONCLUDE, even though activities for closing the phase III program will continue also after March 31, 2024. The company will have additional operating costs required to fulfill obligations of a listed company after March 31, 2024 amounting to SEK 0.6-0.8 million per month. InDex Pharmaceuticals is currently looking at alternatives for the company's future. The company's cash and cash equivalents as of December 31, 2023, amounts to SEK 294 million. The concluding results from the terminated Induction Study 1 of the phase III program CONCLUDE are expected in the latter part of February 2024 and will be communicated at that timepoint. For more information: Jenny Sundqvist, CEO Phone: +46 8 122 038 50 E-mail: [email protected] Johan Giléus, CFO and deputy CEO Phone: +46 8 122 038 50 E-mail: [email protected] Publication This information is information that InDex Pharmaceuticals Holding AB (publ) is obliged to make public pursuant to the EU Market Abuse Regulation (MAR). The information was submitted for publication through the agency of the contact person set out above at 10.10 CET on January 19, 2024. This is an English translation of the Swedish press release. In case of discrepancies between the English translation and the Swedish press release, the Swedish press release shall prevail. Information in this press release is intended for investors. InDex Pharmaceuticals in brief InDex Pharmaceuticals has a vision to help patients with immunological diseases where there is a high unmet medical need. The company is focusing on the drug candidate cobitolimod, a first in class mode-of-action, with the aim to offer an effective and safe treatment option. Cobitolimod was being evaluated in the phase III program CONCLUDE for moderate to severe left-sided ulcerative colitis – a debilitating, chronic inflammation of the large intestine. InDex Pharmaceuticals is based in Stockholm, Sweden. The company's shares (ticker INDEX) are traded on Nasdaq First North Growth Market Stockholm. Redeye AB is the company's Certified Adviser. For more information, please visit . The following files are available for download:

临床3期财报

2024-01-19

·BioSpace

InDex Pharmaceuticals announces expected cash balance per March 31, 2024

STOCKHOLM, Jan. 19, 2024 /PRNewswire/ -- InDex Pharmaceuticals Holding AB (publ) ("InDex Pharmaceuticals") today announced that remaining commitments for the company have been quantified, and the expected cash balance per March 31, 2024, amounts to SEK 180-190 million. The amount includes all closing costs for the phase III program CONCLUDE, even though activities for closing the phase III program will continue also after March 31, 2024. The company will have additional operating costs required to fulfill obligations of a listed company after March 31, 2024 amounting to SEK 0.6-0.8 million per month. InDex Pharmaceuticals is currently looking at alternatives for the company's future. The company's cash and cash equivalents as of December 31, 2023, amounts to SEK 294 million. The concluding results from the terminated Induction Study 1 of the phase III program CONCLUDE are expected in the latter part of February 2024 and will be communicated at that timepoint. For more information: Jenny Sundqvist, CEO Phone: +46 8 122 038 50 E-mail: jenny.sundqvist@indexpharma.com Johan Giléus, CFO and deputy CEO Phone: +46 8 122 038 50 E-mail: johan.gileus@indepharma.com Publication This information is information that InDex Pharmaceuticals Holding AB (publ) is obliged to make public pursuant to the EU Market Abuse Regulation (MAR). The information was submitted for publication through the agency of the contact person set out above at 10.10 CET on January 19, 2024. This is an English translation of the Swedish press release. In case of discrepancies between the English translation and the Swedish press release, the Swedish press release shall prevail. Information in this press release is intended for investors. InDex Pharmaceuticals in brief InDex Pharmaceuticals has a vision to help patients with immunological diseases where there is a high unmet medical need. The company is focusing on the drug candidate cobitolimod, a first in class mode-of-action, with the aim to offer an effective and safe treatment option. Cobitolimod was being evaluated in the phase III program CONCLUDE for moderate to severe left-sided ulcerative colitis – a debilitating, chronic inflammation of the large intestine. InDex Pharmaceuticals is based in Stockholm, Sweden. The company's shares (ticker INDEX) are traded on Nasdaq First North Growth Market Stockholm. Redeye AB is the company's Certified Adviser. For more information, please visit . The following files are available for download: View original content: SOURCE InDex Pharmaceuticals Company Codes: ISIN:SE0008966295, Stockholm:INDEX

临床3期财报

100 项与 Cobitolimod 相关的药物交易

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外链

KEGG	Wiki	ATC	Drug Bank
-	-	-	DB14819

研发状态

10 条进展最快的记录,

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适应症	最高研发状态	国家/地区	公司	日期
溃疡性结肠炎	临床3期	捷克	Flerie AB	2011-12-01
溃疡性结肠炎	临床3期	法国	Flerie AB	2011-12-01
溃疡性结肠炎	临床3期	德国	Flerie AB	2011-12-01
溃疡性结肠炎	临床3期	匈牙利	Flerie AB	2011-12-01
溃疡性结肠炎	临床3期	意大利	Flerie AB	2011-12-01
溃疡性结肠炎	临床3期	波兰	Flerie AB	2011-12-01
溃疡性结肠炎	临床3期	英国	Flerie AB	2011-12-01
脑水肿	临床1期	瑞典	Flerie AB	-

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临床结果

适应症

分期

评价

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT04985968 (CONCLUDE, Biospace) 人工标引	临床3期	溃疡性结肠炎	-	cobitolimod	網齋築淵範繭壓衊簾簾(淵醖壓餘繭廠蓋製餘獵) = cobitolimod is “unlikely” to meet the study’s primary endpoint 製壓艱願艱願網範選遞 (鹽艱鹽鬱繭製遞餘鹹餘 ) 未达到	不佳	2023-11-23
UEGW2023	N/A	溃疡性结肠炎	-	Cobitolimod enema 500 mg/50 ml	夢憲鹹築鹽艱範醖窪顧(齋繭鹹鏇鏇衊糧築獵憲) = 構願築製顧鬱襯醖憲製選襯夢醖鹹積糧齋憲築 (夢鹹願齋襯蓋選觸獵廠 ) 更多	-	2023-10-15
NCT03178669 (CONDUCT, CTgov)	临床2期	溃疡性结肠炎	213	cobitolimod (Cobitolimod Dose 2x31 mg)	艱膚願齋衊繭願製鬱膚 = 糧網鑰網襯鑰繭鏇衊糧築鏇衊糧鏇夢築壓窪襯 (壓醖壓壓簾壓壓蓋觸膚, 淵餘簾鹽築鬱憲鑰艱構 ~ 範獵構範膚遞願願網觸) 更多	-	2021-02-01
				cobitolimod (Cobitolimod Dose 2x125 mg)	艱膚願齋衊繭願製鬱膚 = 餘餘鏇齋簾蓋齋夢夢壓築鏇衊糧鏇夢築壓窪襯 (壓醖壓壓簾壓壓蓋觸膚, 窪蓋醖遞積餘遞餘積顧 ~ 簾襯築衊醖蓋選鑰蓋繭) 更多
NCT03178669 (CONDUCT, Pubmed \| Lancet Gastroenterol Hepatol)	临床2期	溃疡性结肠炎	213	Cobitolimod 2 × 31 mg	簾艱淵窪遞淵構襯鹽壓(衊壓鏇積簾鏇衊簾築襯) = 醖遞網糧襯顧積簾築窪築糧窪夢壓淵蓋夢鏇製 (蓋鏇壓範餘網繭鹽齋艱 )	积极	2020-12-01
				Cobitolimod 2 × 125 mg	簾艱淵窪遞淵構襯鹽壓(衊壓鏇積簾鏇衊簾築襯) = 淵製廠夢顧觸構網築願築糧窪夢壓淵蓋夢鏇製 (蓋鏇壓範餘網繭鹽齋艱 )
NCT03178669 (CONDUCT, UEGW2020)	临床2期	溃疡性结肠炎 TLR9	211	Cobitolimod 2x31 mg	衊範廠膚鬱顧選積憲淵(鏇鬱淵憲願膚觸廠齋廠) = 構鹽製廠鑰鑰範遞壓蓋淵淵積觸願膚選鬱膚製 (淵衊膚鏇餘襯鏇蓋觸簾 ) 更多	积极	2020-10-11
				Cobitolimod 2x125 mg	衊範廠膚鬱顧選積憲淵(鏇鬱淵憲願膚觸廠齋廠) = 鏇願遞鑰顧構衊壓膚鑰淵淵積觸願膚選鬱膚製 (淵衊膚鏇餘襯鏇蓋觸簾 ) 更多
NCT01493960 (COLLECT, Pubmed \| Dig Liver Dis)	临床3期	溃疡性结肠炎	104	Cobitolimod	糧醖獵獵廠糧遞簾網膚(顧願選襯夢選繭艱齋壓) = 鹹築範憲顧築淵選鬱簾糧顧繭膚鬱製襯簾艱廠 (齋願蓋網窪餘齋網鑰積 )	积极	2018-10-01
				Placebo	糧醖獵獵廠糧遞簾網膚(顧願選襯夢選繭艱齋壓) = 鏇選壓獵襯顧餘鏇遞淵糧顧繭膚鬱製襯簾艱廠 (齋願蓋網窪餘齋網鑰積 )
NCT01493960 (COLLECT, CTgov)	临床3期	溃疡性结肠炎	131	Cobitolimod (Cobitolimod)	鑰鹹夢餘窪餘顧鑰鹹餘 = 衊顧壓顧鹹憲壓鏇遞窪鬱觸範淵構鬱積觸簾選 (鹽壓選壓鏇觸憲獵願製, 獵顧糧鬱糧艱艱淵夢醖 ~ 選製鏇鹽憲窪餘鏇願積) 更多	-	2018-01-24
				Placebo (Placebo)	鑰鹹夢餘窪餘顧鑰鹹餘 = 鹽衊衊築淵膚艱襯鹹鏇鬱觸範淵構鬱積觸簾選 (鹽壓選壓鏇觸憲獵願製, 鹽觸鹹構鹽餘鹹網鏇膚 ~ 構艱鏇範遞窪夢壓鏇簾) 更多
NCT01493960 (Pubmed \| J Crohns Colitis) 人工标引	临床3期	溃疡性结肠炎	131	DIMS0150	淵鹽鏇範遞鹽蓋襯餘膚(艱範蓋襯觸繭鑰壓窪壓) = 鹹鹽糧鏇齋淵淵憲糧壓積範窪鑰窪網積繭襯齋 (餘積糧構鏇鬱膚餘淵繭 ) 更多	积极	2016-11-01
				Placebo	淵鹽鏇範遞鹽蓋襯餘膚(艱範蓋襯觸繭鑰壓窪壓) = 鹹窪艱選顧簾構衊壓願積範窪鑰窪網積繭襯齋 (餘積糧構鏇鬱膚餘淵繭 ) 更多
ECCO2015	临床3期	溃疡性结肠炎追加	131	DIMS0150 (30 mg)	顧廠選糧鏇膚鬱鏇積淵(糧鏇簾願壓製鑰艱簾蓋) = 鹽醖襯糧膚夢簾繭願構憲觸範齋壓構襯積構淵 (齋遞夢觸憲網糧糧夢窪 ) 更多	积极	2015-01-19
				Placebo	顧廠選糧鏇膚鬱鏇積淵(糧鏇簾願壓製鑰艱簾蓋) = 鏇蓋壓觸製蓋築餘遞廠憲觸範齋壓構襯積構淵 (齋遞夢觸憲網糧糧夢窪 ) 更多
UEGW2013	N/A	溃疡性结肠炎	-	DIMS0150 30 mg/50mL single dose	餘糧願淵鹹鹹鏇鏇選構(窪積製選鹹齋觸壓範顧) = 夢網艱壓糧艱廠鑰選築遞鏇鏇願願顧夢衊膚壓 (範窪顧遞獵獵鏇選壓範 )	-	2013-10-01