Efficacy, safety and tolerability of vidofludimus in patients with inflammatory bowel disease: the ENTRANCE study

J Crohns Colitis. 2013 Sep;7(8):636-43. doi: 10.1016/j.crohns.2012.09.016. Epub 2012 Oct 16.

Abstract

Background: Vidofludimus (SC12267) is a novel oral immunomodulator inhibiting dihydroorotate dehydrogenase (DHODH) and the expression of proinflammatory cytokines including interleukin-17 (IL17A and IL17F) and interferon-gamma. The objective of the study was to explore the efficacy, safety and tolerability of vidofludimus in steroid-dependent inflammatory bowel disease (IBD).

Methods: The open label uncontrolled ENTRANCE study (ClinicalTrials.gov NCT00820365) has been conducted at 13 study centers in Germany, Bulgaria and Romania. Thirty-four steroid-dependent patients with a confirmed diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) were treated with a once daily 35mg oral dose of vidofludimus over 12weeks. Steroids were tapered during the first 8weeks followed by a steroid-free treatment period of 4weeks. Complete response was defined as steroid-free clinical remission at week 12; partial response was defined as being in remission at steroid dose equal or lower than the individual patient's threshold dose for relapse.

Results: Of the thirty-four patients enrolled in this trial 26 were evaluable for primary efficacy assessment. After completion of the 12weeks treatment phase 8 out of 14 (57.1%) patients with CD and 6 out of 12 (50.0%) patients with UC were in steroid-free remission (complete responders). Another 4 (28.6%) patients in CD and 5 (41.7%) patients in UC were partial responders. Vidofludimus was well tolerated, no drug-related serious adverse events were observed.

Conclusions: This trial provides first evidence of clinical efficacy of vidofludimus in IBD. Although the safety and tolerability profile seems favorable, long-term controlled studies are needed to further investigate its potential as novel IBD therapy.

Keywords: Clinical trial; Crohn's disease; IBD; Ulcerative colitis; Vidofludimus.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Azathioprine / therapeutic use
  • Biphenyl Compounds / adverse effects
  • Biphenyl Compounds / therapeutic use*
  • Blood Sedimentation
  • C-Reactive Protein / metabolism
  • Colitis, Ulcerative / blood
  • Colitis, Ulcerative / drug therapy*
  • Crohn Disease / blood
  • Crohn Disease / drug therapy*
  • Dicarboxylic Acids / adverse effects
  • Dicarboxylic Acids / therapeutic use*
  • Dihydroorotate Dehydrogenase
  • Enzyme Inhibitors / adverse effects
  • Enzyme Inhibitors / therapeutic use*
  • Feces / chemistry
  • Female
  • Humans
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use*
  • Immunosuppressive Agents / therapeutic use
  • Intention to Treat Analysis
  • Leukocyte L1 Antigen Complex / analysis
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Oxidoreductases Acting on CH-CH Group Donors / antagonists & inhibitors
  • Prednisolone / therapeutic use
  • Remission Induction
  • Severity of Illness Index
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Biphenyl Compounds
  • Dicarboxylic Acids
  • Dihydroorotate Dehydrogenase
  • Enzyme Inhibitors
  • Immunologic Factors
  • Immunosuppressive Agents
  • Leukocyte L1 Antigen Complex
  • vidofludimus
  • C-Reactive Protein
  • Prednisolone
  • Oxidoreductases Acting on CH-CH Group Donors
  • Azathioprine
  • Methotrexate

Associated data

  • ClinicalTrials.gov/NCT00820365