Treatment of resistance to Mirikizumab

Mirikizumab (Mirikizumab)-Omvoh is a monoclonal antibody targeting the p19 subunit of interleukin (IL)-23, which has shown good efficacy and tolerability in the treatment of moderate to severe ulcerative colitis (UC) in recent years. Although the drug has shown superior efficacy in clinical trials, some patients may still develop drug resistance, resulting in reduced efficacy or recurrence of the disease. Therefore, the treatment of resistance to milizumab is particularly important.

The occurrence of drug resistance may be related to the biological characteristics of individual patients, such as genetic polymorphisms, immune status and pathophysiological changes. When clinicians face drug-resistant cases, they should first assess the patient's initial response, including the severity of the disease at the beginning of treatment and the early response to treatment. In addition, it is necessary to monitor the dynamic changes in disease progression and adjust treatment plans in a timely manner.

For patients who have developed drug resistance, treatment in combination with other immunosuppressants or biological agents can be considered. For example, the use of tumor necrosis factor (TNF or other targeted therapies may enhance the therapeutic effect. In addition, for some patients, local or systemic immunomodulatory therapy can also help. During this process, doctors should develop a personalized treatment plan based on the patient's overall health status and other comorbidities.

Studies have shown that patients may develop specific antibodies after treatment with militizumab, and these antibodies may affect the effectiveness of the drug. By detecting anti-drug antibody levels in serum, it can help determine the cause of drug resistance and adjust treatment strategies based on the results. For example, for patients with elevated antibody levels, increased dosing intervals or doses may be considered to overcome the effects of drug resistance.

Reference materials:https://pubmed.ncbi.nlm.nih.gov/36881820/