Filgotinib appeared effective as a maintenance treatment for moderate to severe ulcerative colitis, with higher rates of 6-month corticosteroid-free remission compared with placebo.

The SELECTION study, which was presented at virtual Digestive Disease Week, included 664 patients who were randomized to receive either 100 mg or 200 mg filgotinib or placebo. Analysis of the efficacy of the treatment only included the 558 patients who received the treatment during the induction phase of the study. About 40% of patients were biologic experienced.

Clinical remission at Week 58 served as the primary endpoint and was defined by a Mayo endoscopic subscore of 1 or less, rectal bleeding subscore of 0, and 1-pt or greater decrease in stool frequency subscore (SFS) from baseline and SFS of 1 or less. 

More patients achieved clinical remission in both the 200 mg filgotinib group (37.2% vs 11.2%, P < .025) and the 100 mg group (23.8 vs 13.5%, P < .05). compared with placebo. 

Overall, 27.2% of patients in the 200 mg group and 13.6% of patients in the 100 mg group achieved 6-month corticosteroid-free clinical remission.

In reviewing the safety data, the authors noted that adverse events, serious adverse events, and discontinuations due to adverse events were similar across all the treatment arms, while serious infection and herpes zoster infection were infrequent. No opportunistic infections were reported, and there were no venous thromboses. Two patients in the higher dose arm died from asthma exacerbation and left ventricular failure, respectively, though the researchers determined neither death was related to the drug.