Anti-IL-23 Therapy Effective in Crohn's Disease Save

Lancet has reported the results of risankizumab, an interleukin-23 (IL-23) inhibitor, in Crohn's disease. Risankizumab is a humanised monoclonal antibody targeting the p19 subunit of interleukin-23, and is being developed for Crohn's disease. Other IL-23 inhibitors are currently under tudy for inflammatory bowel disease, psoriasis, psoriatic arthritis, and spondyloarthritis.

This multinational, multicenter study enrolled adults with active Crohn's disease with a Crohn's Disease Activity Index (CDAI) of 220–450, mucosal ulcers and an Endoscopic Index (CDEIS) and were treated with IV 200 mg risankizumab, 600 mg risankizumab, or placebo, at weeks 0, 4, and 8. The primary outcome was clinical remission (CDAI <150) at week 12.

A total of 213 patients were screened, and 121 patients  By week 12, 31% of 82 risankizumab patients had clinical remission compared with only 15% of placebo patients (p=0·0489). Higher rates of remission were seen in those receive=ing the 600 mg dose compared to the 200 mg dose (20·9% vs 9%).

The most common adverse event was nausea and most common serious adverse event was worsening of underlying Crohn's disease. No deaths occurred.

Risankizumab was more effective than placebo for inducing clinical remission in patients with active Crohn's disease. These results may have been lessened by the fact that >90% of enrollees were TNF inhibitor failures.

Selective blockade of interleukin-23 via inhibition of p19 might be a viable therapeutic approach in Crohn's disease.