K Jimbo et al. Inflammatory Bowel Diseases 2026; 32: 711-720. Real-World Effectiveness of and Optimization Strategies for Mirikizumab in Pediatric Ulcerative Colitis: A Prospective, Observational Study
Methods: This prospective cohort study included Japanese children (n=28) with UC receiving intravenous mirikizumab (300 mg at weeks 0, 4, 8), followed by subcutaneous maintenance (200 mg every 4 weeks). The cohort had a median age 13 years (50% female) with a median PUCAI 67.5; 67.4% were biologics-naive. In those with clinical remission at 12 weeks, sucutaneous injections were started; otherwise, IV infusions (prolonged induction, n=11) continued every 4 weeks. Complete remission was defined as PUCAI<10 and colonic wall thickness on IUS <3.0 mm with no detectable color Doppler flow signal throughout the colon.
Key findings:
- The median time to complete remission (CR) was 10 weeks. All patients ultimately achieved CR
- Durable CR was achieved in 27/28 (96%).
- SF-CR generally increased over time: 17/28 (61%) at week 12, 28/28 (100%) at week 24, and 27/28 (96%) at wek 52
- No serious adverse events were noted. 6 children developed self-limiting flu-like symptoms
Limitations included relatively small number of patients at a single center. Also, the majority of patients had not received prior advanced therapies.
My take: It is encouraging to see favorable pediatric data. Though, the complete remission rate of 100% will likely be an outlier as more data become available.
Related blog posts:
- Pediatric Data for Mirkizumab –SHINE-1 Trial
- Efficacy of Mirikizumab in Ulcerative Colitis: LUCENT-3 Study Results
- Efficacy of Mirikizumab in Moderate-to-Severe Crohn’s Disease (VIVID-1 Study)
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