Mirikizumab for the treatment of moderate to severe ulcerative colitis

Immunotherapy. 2023 Oct;15(15):1199-1208. doi: 10.2217/imt-2023-0012. Epub 2023 Jul 19.

Abstract

Despite a growing number of available therapeutic options for ulcerative colitis (UC), up to 50% of patients do not respond to initial treatment or lose response over time, highlighting the need for novel therapies. The IL-23 pathway has emerged as an important therapeutic target for UC. Mirikizumab is a humanized IgG4 monoclonal antibody against the p19 subunit of IL-23, dosed intravenously during induction and subcutaneously during maintenance. It is effective for the induction and maintenance of remission in moderately to severely active UC, including patients with prior failure of biological or tofacitinib therapy. Like other IL-23 antagonists, mirikizumab has a favorable safety profile. It is the first agent of its class to receive regulatory approval for moderately to severely active UC in Europe.

Keywords: IL-23; biological therapy; clinical trials; inflammatory bowel disease; therapeutic monoclonal antibodies.

Plain language summary

Despite a growing number of available therapeutic options for ulcerative colitis (UC), up to 50% of patients do not respond to initial treatment or lose response over time, highlighting the need for novel therapies. A molecule promoting inflammation in the colon called IL-23 is a promising target for new drugs that treat UC. Mirikizumab is an antibody that works against a portion of IL-23 and thus suppresses inflammation in the colon. Mirikizumab was shown to be effective in alleviating symptoms and resolving inflammation of the colon in patients with UC. The drug was safe and well tolerated by patients. Mirikizumab is the first drug of its kind to receive approval for UC in Europe.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Colitis, Ulcerative* / drug therapy
  • Europe
  • Humans
  • Interleukin-23

Substances

  • mirikizumab
  • Antibodies, Monoclonal, Humanized
  • Interleukin-23