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DOI: 10.1055/s-0045-1810776
Change in pruritus in patients with primary biliary cholangitis and moderate to severe pruritus: a pooled analysis from the RESPONSE and ENHANCE studies
Authors
Introduction: Seladelpar (SEL) is a first-in-class delpar (selective PPAR-delta agonist) indicated for the treatment of PBC in combination with ursodeoxycholic acid (UDCA) in adults who have an inadequate response to UDCA, or as a monotherapy in pts unable to tolerate UDCA. In two Phase 3, placebo (PBO)-controlled trials (ENHANCE [NCT03602560] and RESPONSE [NCT04620733]), SEL significantly reduced pruritus among pts who had moderate to severe pruritus (numerical rating scale [NRS]≥4) at baseline (BL).
Objectives: Here, we present pooled pruritus outcomes across different measures of itch in pts with PBC from RESPONSE and ENHANCE with NRS≥4 at BL.
Methodology: Pts with PBC were randomised 1:1:1 to daily SEL 5 mg, SEL 10 mg, or PBO for 52 weeks in ENHANCE and 2:1 to daily SEL 10 mg or PBO for 52 weeks in RESPONSE (ENHANCE terminated early with key endpoints amended to month [M] 3). Pooled data from pts with NRS≥4 at BL who received SEL 10 mg or PBO in RESPONSE and at least 6 M in ENHANCE were analysed. In a post hoc analysis, changes across several measures of itch up to M6 (NRS, PBC-40 itch domain, and the 5-D itch scale) were assessed.
Results: Of the 126 pts with moderate to severe pruritus, 76 and 50 received SEL 10 mg and PBO, respectively, in RESPONSE or ENHANCE. Most pts at BL were<50 years old at age of PBC diagnosis (73/126) and had a history of pruritus (122/126) and fatigue (77/126). NRS, PBC-40 itch domain, and 5-D itch scale scores were similar between the SEL and PBO groups at BL. At M6, pts who received SEL experienced greater improvements in NRS scores (mean change from BL of−3.12 vs−2.09 for SEL and PBO, respectively, p=.0004), PBC-40 itch domain scores (mean change from BL of−2.26 vs−1.37 for SEL and PBO, respectively, p=.0227), 5-D itch total scores (mean change from BL of−4.85 vs−2.30 for SEL and PBO, respectively, p<.0001), and 5-D itch degree domain scores (mean change from BL of−0.96 vs−0.54 for SEL and PBO, respectively, p=.0005). The overall safety profiles in pts with pruritus in the SEL and PBO groups were similar in this pooled analysis. Adverse events occurred in 58/76 (76%) SEL and PBO 40/50 (80%) PBO pts.
Conclusion: In agreement with previous studies, this pooled analysis indicates that up to 6 M of SEL treatment reduced pruritus to a greater extent vs PBO in pts with PBC who had moderate to severe pruritus when assessed across 3 different measures of itch. SEL was well tolerated in this pt population.
Publikationsverlauf
Artikel online veröffentlicht:
04. September 2025
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