A first-in-class oral IL-23 inhibitor, icotrokinra, is showing impressive long-term results for ulcerative colitis. In the ANTHEM-UC phase 2b trial extension, over half of patients achieved clinical remission at week 76, with 97% remaining steroid-free. Experts say the once-daily pill could be a game-changer for patients reluctant to use injectables or infusions.
A first-in-class oral drug is turning heads in the world of inflammatory bowel disease. Icotrokinra, an oral interleukin-23 (IL-23) inhibitor developed by Johnson & Johnson, demonstrated sustained efficacy and a strong safety profile through 76 weeks in patients with moderately to severely active ulcerative colitis (UC), according to long-term data from the phase 2b ANTHEM-UC trial presented at the ACG Annual Scientific Meeting and published in The New England Journal of Medicine.
Unlike existing IL-23 inhibitors that require injections or infusions, icotrokinra is taken once daily by mouth — a distinction that could significantly improve patient adherence. Lead researcher Dr. Maria T. Abreu of Cedars-Sinai called it "an easier sell," noting that many UC patients are reluctant to start injectable or infusion-based advanced therapies.
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Why it matters: With patients historically resistant to injectable biologics, a once-daily oral option that delivers comparable efficacy to parenteral IL-23 inhibitors — and gets patients off steroids — could reshape how moderate-to-severe UC is managed. Phase 3 trials are ongoing.
