Ulcerative Colitis Remission Status After Induction With Mesalazine Predicts Maintenance Outcomes: the MOMENTUM Trial

Abstract

Background and aims: This study assessed the efficacy of maintenance treatment with multimatrix mesalazine following achievement of complete or partial remission after induction treatment with high-dose multimatrix mesalazine.

Methods: In this phase 3b/4, open-label, multicentre, prospective, single-arm study, patients with mild-to-moderate ulcerative colitis were treated with multimatrix mesalazine 4.8g/day once daily for 8 weeks [induction phase]. At Week 8, those who achieved complete or partial remission, based on predefined clinical and endoscopic criteria, were eligible to receive 12 months of multimatrix mesalazine 2.4g/day once daily maintenance therapy. The primary endpoint was the proportion of patients in complete remission at Month 12.

Results: A total of 717 patients received induction treatment; 25.9% and 39.3% of patients achieved complete and partial remission, respectively, at Week 8. A total of 461 patients entered the maintenance phase. The likelihood of remaining in/achieving complete remission at Month 12 was higher for patients who entered the maintenance phase in complete remission compared with those who began maintenance in partial remission [47.8% vs 26.0%; p < 0.001]. At Month 12, mucosal healing [endoscopy score ≤ 1] was demonstrated in 76.4% [139/182] and 63.5% [176/277] of those who were in complete and partial remission, respectively, at the end of induction.

Conclusion: Patients achieving complete remission before dose reduction were more likely to remain in remission at Month 12.

Keywords: 5-aminosalicylic acid [5-ASA]; Inflammatory bowel disease; MOMENTUM.

Figure 1.

Study design. QD, once daily; 5-ASA, 5-aminosalicylic acid.

Figure 2.

Patient flow diagram.

Figure 3.

[A] Rectal bleeding scores and [B] stool frequency scores at baseline, Month 0, and Month 12 among patients who achieved complete or partial response at Month 0; maintenance phase efficacy population [n = 459]. Percentages at Month 12 do not add up to 100% due to the absence of scores from patients who discontinued the study before Month 12.

Figure 3.

[A] Rectal bleeding scores and [B] stool frequency scores at baseline, Month 0, and Month 12 among patients who achieved complete or partial response at Month 0; maintenance phase efficacy population [n = 459]. Percentages at Month 12 do not add up to 100% due to the absence of scores from patients who discontinued the study before Month 12.

Figure 4.

Endoscopy scores at baseline, Month 0, and Month 12 among patients who achieved complete or partial response at Month 0; maintenance phase efficacy population [n = 459]. Percentages at Month 12 do not add up to 100% due to the absence of scores from patients who discontinued the study before Month 12.