Maia Kayal, MD, on Interleukin-23s in IBD
Dr Kayal discusses her presentation at the AIBD regional meeting on the efficacy and safety of IL-23 inhibitors in the treatment of inflammatory bowel disease.
Maia Kayal, MD, is an assistant professor in the Division of Gastroenterology at the Icahn School of Medicine at Mount Sinai in New York City, New York.
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TRANSCRIPT:
Maia Kayal:
My name is Maia Kayal. I'm an assistant professor in the division of gastroenterology at the Icahn School of Medicine in New York City. This morning at the regional AIBD virtual conference, I spoke about the increasing use of anti-IL-23 antibodies in inflammatory bowel disease.
Anti-IL-23 antibodies such as guselkumab, mirikizumab, and risankizumab selectively bind to the p19 subunit of IL-23. They inhibit its interaction with the receptor complex and they reduce IL-23 gene [inaudible 00:00:44] expression. And this is important and novel because we know that IL-23 drives development of inflammatory pathogenic T helper cells and the IL-23 pathway components are overexpressed in IBD. And so with the novel use of anti-IL-23 and their development, we've been seeing increasing efficacy with clinical response, remission, and endoscopic outcomes in patients with Crohn's disease and ulcerative colitis.
We know that risankizumab was the most recently approved IL-23 antibody for patients with Crohn's disease with excellent efficacy and safety. We have also seen from the recent Phase 3 LUCENT studies the use of mirikizumab in patients with ulcerative colitis. In the LUCENT studies, there was a novel secondary outcome of bowel urgency, which is the first study to actually look at this outcome in patients with ulcerative colitis, and we see from the mirikizumab induction data that patients started to have a decrease in bowel urgency as early as week two. We also reviewed the use of guselkumab in patients with Crohn's disease and we looked at the GALAXI trial, which showed again excellent clinical efficacy and outcomes for patients with Crohn's disease.
The increasing use of anti-IL-23 antibodies for patients with Crohn's disease and ulcerative colitis is exciting because we know that the safety is excellent and very manageable and that these medications work in patients regardless of their biologic exposure or history and that they have excellent efficacy outcomes in both clinical response, remission, and endoscopic outcomes as well.
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