The Role of IL-23 Inhibitors in Crohn’s Disease

Author:

Fanizza Jacopo1,D’Amico Ferdinando12ORCID,Lusetti Francesca13ORCID,Fasulo Ernesto1,Allocca Mariangela1,Furfaro Federica1,Zilli Alessandra1,Parigi Tommaso Lorenzo1,Radice Simona1,Peyrin-Biroulet Laurent456789,Danese Silvio1,Fiorino Gionata110

Affiliation:

1. Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, 20132 Milan, Italy

2. Department of Biomedical Sciences, Humanitas University, 20089 Milan, Italy

3. Department of Gastroenterology, IRCCS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy

4. Department of Gastroenterology, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France

5. Inserm, NGERE, University of Lorraine, F-54000 Nancy, France

6. INFINY Institute, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France

7. FHU-CURE, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France

8. Groupe Hospitalier Privé Ambroise Paré-Hartmann, Paris IBD Center, F-92200 Neuilly-sur-Seine, France

9. Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, QC H4A 3J1, Canada

10. IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy

Abstract

Promoting a Th17 pathogenic response, the interleukin (IL)-23 pathway is crucial in the pathophysiology of inflammatory bowel disease (IBD). With a favorable safety profile, ustekinumab, a monoclonal antibody targeting the shared p40 component of IL-12/23, is currently approved for the treatment of IBD in patients with disease refractory to corticosteroids and biologic drugs. Risankizumab, mirikizumab, and guselkumab are specific IL-23p19 antagonists tested for the treatment of Crohn’s disease (CD). However, only risankizumab currently has been approved for its treatment. Trials with guselkumab and mirikizumab are currently ongoing, with promising preliminary efficacy and safety results. In this review, we provide a summary of the current knowledge about selective IL-23 inhibitors, focusing on their positioning in the therapeutic algorithm of patients with moderate to severe CD.

Publisher

MDPI AG

Subject

General Medicine

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