From the Research
Effectiveness of Rotating to a Different IL-23 Inhibitor
- The effectiveness of rotating to a different IL-23 inhibitor in patients with Crohn's disease or ulcerative colitis who fail initial IL-23 inhibitor treatment is not directly addressed in the provided studies 1, 2, 3, 4, 5.
- However, the studies suggest that IL-23 inhibitors are effective in treating Crohn's disease and ulcerative colitis, with several agents showing promising results in clinical trials 2, 3, 4, 5.
- A systematic review and meta-analysis found that targeting IL-23 was significantly superior to placebo for inducing clinical and endoscopic remission and maintaining clinical remission in patients with moderate-to-severe Crohn's disease 5.
- The review also found that targeting IL-23 was effective in both biologic-naïve and biologic-experienced patients, although the certainty of evidence was higher for biologic-naïve patients 5.
Potential for Rotation to a Different IL-23 Inhibitor
- While the provided studies do not directly address the effectiveness of rotating to a different IL-23 inhibitor, they do suggest that different IL-23 inhibitors may have different efficacy and safety profiles 2, 3, 4.
- For example, a review of IL-23 inhibitors found that risankizumab, mirikizumab, brazikumab, and guselkumab are currently in advanced clinical trials for either Crohn's disease or ulcerative colitis, and that these agents may have different mechanisms of action and efficacy profiles 2.
- Another review found that pre- and post-treatment levels of IL-22 and post-treatment levels of IL-17 may be potential molecular predictors of response to IL-23 inhibition, which could inform decisions about rotating to a different IL-23 inhibitor 3.
Limitations of Current Evidence
- The provided studies are limited by their focus on the efficacy and safety of IL-23 inhibitors in general, rather than the specific question of rotating to a different IL-23 inhibitor in patients who fail initial treatment 1, 2, 3, 4, 5.
- Further research is needed to determine the effectiveness of rotating to a different IL-23 inhibitor in patients with Crohn's disease or ulcerative colitis who fail initial IL-23 inhibitor treatment 1, 2, 3, 4, 5.