Cobitolimod

Atreya R, et al. Digestive and Liver Disease, 2018, 50(10), 1019-1029.

Cobitolimod, a Toll-like receptor 9 (TLR-9) agonist, represents a novel therapeutic option for patients with moderate-to-severe ulcerative colitis (UC). Its clinical efficacy was evaluated in the COLLECT study, focusing on patient-reported outcomes (PRO) that defined symptomatic remission (SR) based on e-diary entries recording stool frequency (SF) and the absence of blood in stool.
In this randomized, multicenter clinical trial, cobitolimod was administered topically to 104 UC patients. SR, defined as a mean daily SF of <4 and no visible blood in stool, was assessed at weeks 4, 8, and 12. At week 4, 17.1% of cobitolimod-treated patients achieved SR compared to 5.9% in the placebo group (p = 0.13). By week 8, SR rates rose to 35.7% in the cobitolimod group versus 17.6% with placebo (p = 0.07), and at week 12, SR was observed in 38.6% of cobitolimod patients versus 17.6% with placebo (p = 0.04). These results indicate statistically significant efficacy at the 12-week mark.
Efficacy trends were consistent across subgroups, including anti-TNFα-naïve and anti-TNFα-experienced patients, although SR rates were reduced in the latter. Notably, cobitolimod demonstrated enhanced efficacy in patients with moderate UC compared to severe cases.
This post-hoc analysis underscores cobitolimod's ability to induce remission in UC as defined by PRO metrics, marking it as a promising treatment option.