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Review
. 2025 Feb 5;14(3):1001.
doi: 10.3390/jcm14031001.

Role of Mirikizumab in the Treatment of Inflammatory Bowel Disease-From Bench to Bedside

Michael Colwill  1   2 , Samantha Baillie  1   2 , Jennifer Clough  1   3 , Richard Pollok  1   2 , Andrew Poullis  1   2 , Kamal Patel  1 , Sailish Honap  1   3
Affiliations
Review

Role of Mirikizumab in the Treatment of Inflammatory Bowel Disease-From Bench to Bedside

Michael Colwill et al. J Clin Med. .

Abstract

Mirikizumab is a monoclonal antibody directed against the p19 subunit of interleukin (IL)-23 to inhibit its interaction with the IL-23 receptor. IL-23 is a key cytokine involved in initiating and perpetuating the inflammatory cascade in inflammatory bowel disease (IBD). Mirikizumab is the first agent from the novel anti-IL-23p19 drug class to be licensed for ulcerative colitis and the first to present long-term endoscopic, histologic, symptomatic, and quality-of-life outcomes. More recently, the VIVID trial programme has led to the approval of mirikizumab in moderate to severe Crohn's disease. This review explores the history of its development, discusses key immunopharmacological properties unique to the drug, and details the available clinical trials and real-world evidence supporting its use in IBD.

Keywords: IL-23p19 inhibitor; inflammatory bowel disease; mirikizumab.

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Conflict of interest statement

M.C. served as a speaker and an advisory board member of or has received grants from Pfizer, Celltrion, Ferring, and Dr. Falk. J.C. served as a speaker and an advisory board member of or has received grants from Abbvie, Takeda, Lilly, Johnson and Johnson, and Galapagos. J.C. is an associated editor of Frontline Gastroenterology. S.B. has had speaker arrangements with Takeda and Dr. Falk, has received a travel grant from Galapagos, and has provided consultancy to Galapagos. R.P. and A.P. have no conflicts of interest. K.P. has received honoraria for educational meetings and speaker fees from Abbvie, Janssen, Takeda, Dr. Falk Pharma, PredictImmune, Pfizer, and Ferring and has received advisory board fees from Abbvie, Galapagos, Pfizer, and Janssen. S.H. served as a speaker, a consultant, and an advisory board member or has received grants from Pfizer, Janssen, AbbVie, Takeda, Ferring, Lilly, Pharmacosmos, and Banook Group.

Figures

Figure 1
Figure 1
Mirikizumab is a humanised IgG monoclonal antibody specific to the p19 subunit of IL-23. Interleukin (IL)-23 is a heterodimeric cytokine comprised of p19 and p40 subunits. The p40 subunit is also shared by the heterodimeric cytokine IL-12, which is additionally comprised of a p35 subunit. The receptor for IL-23 is composed of an IL-12Rβ1 and IL-23R chain. The receptor for IL-12 is composed of two different subunits, IL-12Rβ1 and IL-12Rβ2. Binding of IL-23 or IL-12 to their respective receptor results in conformational changes in the receptor, which induce autophosphorylation of Janus kinase (JAK) 2 and tyrosine kinase (TYK) 2, leading to activation of signal transducers and activators of transcription (STATs).
Figure 2
Figure 2
Schematic of the trial designs for LUCENT and VIVID trial programmes.
See this image and copyright information in PMC

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