IL-23 Monoclonal Antibodies for IBD: So Many, So Different?

Abstract

Interleukin [IL]-23 is a member of the IL-12 family of cytokines and has been implicated in multiple inflammatory disorders including psoriasis, psoriatic arthritis, and the inflammatory bowel diseases [IBDs]. Blockade of both IL-12 and IL-23 using an antibody that targets a shared subunit is highly effective in treating psoriasis, and recent data suggest similar efficacy in IBD with minimal adverse events. In this review, we summarise published data on the efficacy of anti-IL-12/23 therapies in IBD as well as emerging data on more selective anti-IL-23 specific therapies. Last, we discuss novel therapeutics under development which target the IL-23 pathway in unique ways and suggest that a biomarker-driven approach will soon guide clinicians to prescribe anti-IL-23 therapies to the patients most likely to respond to them.

Keywords: IL-23; Inflammatory bowel disease; monoclonal antibody.

Figure 1.

Molecular targets of anti-IL-23 therapies. First generation [blue box], second generation [green box], and third generation [brown box] anti-IL-23 therapies are displayed. Created with biorender.com.