Raymond Cross, MD, on Anti-Interleukins for IBD

Dr Cross reviews the mechanism of action of the anti-interleukin 12/23 and 23, the rationale supporting their efficacy in the treatment of IBD, and how to position these and other agents.

Raymond Cross, MD, is a professor of medicine and director of the IBD Program at the University of Maryland School of Medicine in Baltimore.

Hello everyone, I'm Raymond Cross from the University of Maryland School of Medicine where I am professor of medicine and director of the IBD program and I am at the AIBD regional. I just did a talk on IL -12/23 inhibitors for the treatment of IBD. During that 45-minute presentation we covered a variety of topics including how to position therapies in general in treatment of patients with IBD, and then the rationale behind inhibition of IL -12 -23 as a treatment strategy for IBD.

The initial agent approved in this class is ustekinumab, which inhibits both P -19 and P -40 subunits, thus inhibiting both IL -12 and -23. We reviewed the pivotal clinical trials of ustekinumab for Crohn's disease and ulcerative colitis and reviewed the SEAVUE trial, which compared ustekinumab to adalimumab and failed to demonstrate superiority of either agent over one another for the treatment of Crohn's disease. We then looked at our newer drugs, the P -19 inhibitors, including risankizumab, mirikizumab, and a drug to be at the bedside soon, guselkumab, and reviewed their pivotal trials as well. We also reviewed the head -to -head SEQUENCE study comparing ustekinumab and risankizumab, which showed that risankizumab is noninferior to ustekinumab for clinical remission at 6 months, but is in fact superior for endoscopic outcomes at both 6 months and 1 year in biologic-exposed patients. We then talked a little bit about some of the mechanistic differences between risankizumab and guselkumab and how potentially they may impact efficacy in the future. And this is really of course more hypothetical and it has not been proven yet that one is better than the other.

And then lastly we talked about combination therapy. So really some of the newer studies with guselkumab and golimumab, the VEGA study, and then a preview into the Duet CD and the Duet UC studies.

So hopefully you got to view my presentation and enjoy it and I hope to see you at the next regional.