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. 2019 Feb 14;13(9):1217–1226. doi: 10.1093/ecco-jcc/jjz038

Table 3.

Permitted previous and concomitant therapies in clinical trials of advanced therapies for the treatment of ulcerative colitis.

Clinical trial Prohibited concomitant therapies Permitted concomitant therapies [minimum duration of previous treatment] Tapering of concomitant corticosteroids
Infliximab
ACT 1 and ACT 2
[induction and maintenance]
• Rectally administered corticosteroids or rectal 5-ASA [2 weeks] • Corticosteroids [minimum not stated]
• Thiopurines [minimum not stated]
• 5-ASA [minimum not stated; ACT 2 only]
Mandatory attempt; after Week 8: 5 mg/week until a dose of 20 mg/day; thereafter, 2.5 mg/week until discontinuation
Adalimumab
ULTRA 1
[induction],
ULTRA 2
[induction and maintenance]
• Intravenously administered corticosteroids [2 weeks]
• Cyclosporine, tacrolimus, mycophenolate mofetil, or methotrexate [30 days]
• Therapeutic enema or suppository [14 days]
• Investigational drugs [30 days or five half-lives]
• Corticosteroids ≥20 mg/day [14 days]
• Corticosteroids <20 mg/day [40 days]
• Azathioprine ≥1.5 mg/kg/day or 6-mercaptopurine ≥1 mg/kg/day [90 days; stable for 28 days]
• 5-ASA [stable dose; minimum not stated]
Not mandatory; after Week 8: at the discretion of the investigator
Golimumab
PURSUIT-SC
[induction],
PURSUIT-M
[maintenance]
• Anti-TNF, B-, or T-cell-depleting agents [12 months]
• Cyclosporine, tacrolimus, sirolimus, mycophenolate mofetil [8 weeks]
• Investigational drugs [five half-lives]
• Corticosteroids ≤40 mg/day [stable for 2 weeks]
• Thiopurines [stable for 4 weeks]
• 5-ASA [stable for 2 weeks]
Mandatory attempt; from Week 1 of maintenance: 5 mg/week [for doses >20 mg/day] or 2.5 mg/week [for doses ≤20 mg/day]
Vedolizumab
GEMINI 1 [induction],
GEMINI 1 [maintenance]
• Anti-TNF [60 days]
• Cyclosporine, thalidomide, or investigational drugs [30 days]
• Corticosteroids ≤30 mg/day [stable for 4 weeks; 2 weeks if being tapered]
• Thiopurines [stable for 8 weeks]
• 5-ASA [stable for 2 weeks]
• Probiotics [stable for 2 weeks]
• Anti-diarrhoeals [no minimum]
Mandatory attempt if clinical response achieved; from Week 6 or as soon as clinical response achieved: 5 mg/week [for doses >10 mg/day] or 2.5 mg/week [for doses ≤10 mg/day]; dose could be increased to the original dose with tapering to resume within 2 weeks
Tofacitinib
OCTAVE Induction 1 & 2 [induction],
OCTAVE Sustain [maintenance]
• Thiopurines or methotrexate [2 weeks]
• Anti-TNF or interferon therapy [8 weeks]
• Intravenously administered corticosteroids or rectally administered corticosteroids or 5-ASA [2 weeks]
• Anti-adhesion molecule therapy, lymphocyte depleting agents, other immunosuppressants, or immunomodulatory biologics [1 year]
• Oral glucocorticoids ≤25 mg/day [stable throughout induction]
• 5-ASA [stable throughout induction]
Mandatory attempt from Week 1 of maintenance: 5 mg/week [for doses >20 mg/day] or 2.5–5 mg/week [for doses 11–20 mg/day] or 2.5 mg/week [for doses ≤10 mg/day]; dose could be increased once during the study to the previous dose with tapering subsequently resumed to achieve steroid-free status. Inability to complete taper was counted as treatment failure per protocol
Ozanimod
TOUCHSTONE
[induction and maintenance]
• Immunomodulatory biologics [4 months]
• Biologic agent or investigational drug [five half-lives]
• Rectally administered steroids [2 weeks]
• Live vaccine [4 weeks]
• Corticosteroids ≤20 mg/day [4 weeks, stable for 2 weeks]
• 5-ASA [6 weeks, stable for 3 weeks]
Not mandatory; after Week 8: at the discretion of the investigator

Corticosteroid doses given are for prednisone or equivalent dose of other corticosteroid.

5-ASA, 5-aminosalicylates; TNF, tumour necrosis factor.