Effectiveness and safety of mirikizumab in multirefractory ulcerative colitis: analysis from a real-world…

Cohort studyDigestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver· Jul 2026

Effectiveness and safety of mirikizumab in multirefractory ulcerative colitis: analysis from a real-world cohort.

Laura Melotti, Ottavia Monicelli, Nikolas Konstantine Dussias … Fernando Rizzello

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Colon & Rectal SurgeryCohort studyTreatmentQ1IF 3.2

Steroid-free remission occurred in about one-quarter of multirefractory ulcerative colitis patients by week 12.

Effectiveness and safety of mirikizumab in multirefractory ulcerative colitis: analysis from a real-world cohort.

Laura Melotti … Fernando Rizzello

Digestive and liver disease · Jul 2026 · Q1 in Gastroenterology

Background

Mirikizumab is a selective anti-IL-23 monoclonal antibody approved for moderate-to-severe ulcerative colitis (ulcerative colitis).

Methods

We conducted an observational study including ulcerative colitis patients treated with mirikizumab.

Results

about 1 in 4 patients reached drug free, steroid free remission by week 12

SFCR W12

25.2%

SFCR W24

31.3%

More results

Most patients (89.0%) continued extended IV induction after W12.

Bowel urgency improved at W12 and W24 (p<0.001).

Adverse events occurred in 20.3% of patients; the colectomy rate was 4.9%.

Higher baseline Mayo and prior JAKi exposure were associated with lower remission.

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Conclusion

Mirikizumab showed encouraging effectiveness and safety in multirefractory ulcerative colitis. Prior JAKi exposure emerged as a potential negative predictor of remission; this hypothesis-generating signal warrants validation.

Effectiveness and safety of mirikizumab in multirefractory ulcerative colitis: analysis from a real-world cohort.

Effectiveness and safety of mirikizumab in multirefractory ulcerative colitis: analysis from a real-world cohort.

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