mirikizumab at a glance
Medicine class
Humanised monoclonal antibody and selective IL-23 inhibitor
Licensed uses
Moderately to severely active ulcerative colitis and Crohn’s disease in adults after inadequate response, loss of response or intolerance to other treatment
How it is given
Treatment begins with intravenous infusion; maintenance treatment uses injections under the skin
What is mirikizumab used for?
Licensed uses in adults are:
Moderately to severely active ulcerative colitis after inadequate response, loss of response or intolerance to conventional therapy or a biological treatment.
Moderately to severely active Crohn’s disease after inadequate response, loss of response or intolerance to conventional therapy or a biological treatment.
How does mirikizumab work?
Mirikizumab binds selectively to the p19 subunit of interleukin-23 and prevents it activating its receptor. This reduces immune pathways and inflammatory signals involved in ulcerative colitis and Crohn’s disease.
mirikizumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 300 mg
Injection
Route: Parenteral
Strengths: 100 mg, 200 mg
How to take mirikizumab
The infusion concentrate is prepared and administered by healthcare professionals. During maintenance treatment, a patient or caregiver may use pre-filled pens after training.
Inject under the skin of the abdomen, thigh or back of the upper arm, using a different site each time.
Do not use a pen that has been frozen, damaged, contains particles, or has cloudy or distinctly brown solution.
Do not shake the pen. Store it in its original packaging to protect it from light.
Do not stop treatment without discussing this with the specialist team.
mirikizumab side effects
Common or expected effects
- Injection-site pain, redness or another local reaction
- Upper respiratory tract infections affecting the nose or throat
- Headache
- Joint pain
- Rash
Get urgent medical advice
- Serious allergic reaction, including facial or throat swelling, breathing difficulty, fainting or chest tightness
- Serious infection
- Possible liver injury or clinically important rises in liver enzymes
- Shingles or an infusion-related hypersensitivity reaction
mirikizumab in pregnancy
Human pregnancy information is limited, so product information advises avoiding mirikizumab during pregnancy as a precaution. Anyone pregnant or planning pregnancy should discuss treatment with their gastroenterology and maternity teams.
mirikizumab while breastfeeding
It is not known whether mirikizumab enters human milk. Small amounts of human IgG antibodies can enter milk, particularly during the first days after birth, so the prescriber should balance the benefits of breastfeeding with the benefits of treatment.
mirikizumab interactions
Dedicated interaction studies have not been performed. Vaccination status and all concurrent medicines should be reviewed.
Live vaccines
Avoid during mirikizumab treatment because their safety and immune response have not been established.
5-aminosalicylates, corticosteroids and oral immunomodulators
Clinical and population-pharmacokinetic analyses did not identify an effect on mirikizumab clearance; medicines should still be reconciled by the specialist team.
Common questions about mirikizumab
Answers are fully visible for fast scanning and source review.
Why might a specialist prescribe mirikizumab?
It may be considered for moderately to severely active ulcerative colitis or Crohn’s disease when conventional or biological treatment has not worked adequately, has stopped working or cannot be tolerated.
Is mirikizumab a biologic or an immunosuppressant?
It is a biological monoclonal antibody classified as an interleukin inhibitor. By blocking IL-23, it reduces part of the immune response that drives bowel inflammation.
Can mirikizumab be injected at home?
Maintenance injections may be given by the patient or a caregiver after appropriate training from a healthcare professional.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.