An oral pill for ulcerative colitis is proving it has staying power. Icotrokinra (Icotyde), a first-in-class oral peptide that blocks the interleukin-23 receptor, demonstrated durable long-term efficacy in patients with moderately to severely active ulcerative colitis (UC). Results from the long-term extension of the phase IIb ANTHEM-UC trial, presented at the American College of Gastroenterology annual meeting, showed that the majority of patients remaining on treatment were in clinical response, remission, or endoscopic improvement at week 76 — with no meaningful loss of response over time.

Notably, symptomatic remission was observed as early as week 4 and was maintained or improved through week 76. Even patients previously exposed to advanced therapies achieved clinical remission rates above 50%, a meaningful benchmark in a notoriously hard-to-treat population.

By the Numbers:

• Clinical response rates at week 76: 81.3% (100 mg), 72.7% (200 mg), 72.7% (400 mg)
• Clinical remission rates: ~56–59% across all doses
• 97% of patients in remission were corticosteroid-free
• 85% of participants stayed in the long-term extension through week 76

Why it matters: Unlike existing biologics that require injections, icotrokinra is an oral drug with an early onset of action and a favorable safety profile — a combination that could reshape first-line treatment for UC patients if it earns FDA approval for this indication. The phase III ICONIC-UC trial is now underway.