S1PRM safe, efficacious in severe UC

Use of sphingosine 1-phosphate receptor modulators (S1PRM) demonstrates safety and efficacy in the treatment of moderate-to-severe ulcerative colitis (UC), results of a recent study have shown.

Randomized controlled trials (RCTs) of adults with moderate-to-severe UC treated with S1PRM were searched in several publication databases. Seven eligible RCTs were included in the random effects meta-analysis. Investigators assessed the risk of bias using the Cochrane Risk-of-Bias 2 tool and rated the overall quality of evidence using the GRADE approach.

The eligible RCTs consisted of 1,737 moderate-to-severe UC patients treated with S1PRM.

During induction, S1PRM therapy showed efficacy relative to placebo in terms of clinical remission (risk ratio [RR], 2.65, 95 percent confidence interval [CI], 2.00‒3.53), clinical response (RR, 1.68, 95 percent CI, 1.48‒1.91), endoscopic improvement (RR, 2.17, 95 percent CI, 1.76‒2.68), endoscopic normalization (RR, 2.56, 95 percent CI, 1.58‒3.83), mucosal healing (RR, 2.88, 95 percent CI, 1.94‒4.2), and histologic remission (RR, 2.42, 95 percent CI, 1.60‒3.66).

These results persisted throughout the maintenance period, but data available for pooling were fewer. Both sustained (RR, 3.57, 95 percent CI, 1.23‒10.35) and steroid-free remission (RR, 2.92, 95 percent CI, 1.35‒6.33) significantly increased with S1PRM.

In addition, adverse events (RR, 1.02, 95 percent CI, 0.90‒1.15) and infections (RR, 1.15, 95 percent CI, 0.82‒1.60) did not differ significantly between S1PRM and placebo.