mirikizumab for treating moderately to severely active ulcerative colitis (UC)

Last edited 10/2023 and last reviewed 11/2023

Mirikizumab for treating moderately to severely active ulcerative colitis

Mirikizumab is a p19-directed antibody against interleukin-23.

It has been shown that mirikizumab was more effective than placebo in inducing and maintaining clinical remission in patients with moderately to severely active ulcerative colitis (1).

NICE state:

Mirikizumab is recommended as an option for treating moderately to severely active ulcerative colitis in adults when conventional or biological treatment cannot be tolerated, or the condition has not responded well enough or lost response to treatment, only if:

• a tumour necrosis factor (TNF)-alpha inhibitor has not worked (that is the condition has not responded well enough or has lost response to treatment) or

• a TNF-alpha inhibitor cannot be tolerated or is not suitable and

• the company provides it according to the commercial arrangement

The NICE committee note "..TNF-alpha inhibitors are the most used biological treatments for moderately to severely active ulcerative colitis. When TNF-alpha inhibitors have not worked, or are not tolerated, usually people are offered vedolizumab or ustekinumab. Mirikizumab is another biological treatment that would be offered to the same population as these 2 treatments.

Clinical trial evidence shows that mirikizumab is more effective than placebo for treating moderately to severely active ulcerative colitis. But there are no clinical trials directly comparing mirikizumab with vedolizumab or ustekinumab. An indirect comparison suggests that all 3 treatments are similarly effective.."

Reference:

• D'Haens G et al; LUCENT Study Group. Mirikizumab as Induction and Maintenance Therapy for Ulcerative Colitis. N Engl J Med. 2023 Jun 29;388(26):2444-2455.
• NICE (October 2023). Mirikizumab for treating moderately to severely active ulcerative colitis