Introduction: Treatment of ulcerative colitis (UC) aims to control symptoms and to suppress intestinal inflammation. Despite considerable advances, a proportion of patients do not respond to currently available drugs. The interleukin (IL)-23 axis plays a significant role in the pathogenesis of UC and has thus become an important target for drug development.Areas covered: The review briefly summarizes the pathophysiology of the IL-12/23 axis and provides a synopsis of the available evidence for efficacy and safety of ustekinumab, mirikizumab (LY3074828), risankizumab (BI655066/ABBV066), brazikumab (MEDI2070; formerly AMG139) and guselkumab (CNTO1959) in UC. We also provide an overview of ongoing and anticipated trials in this field.Expert opinion: A Phase 2 trial with mirikizumab and a Phase 3 trial with ustekinumab have demonstrated the efficacy of anti-IL-23 agents in achieving clinical and endoscopic outcomes in UC with a favorable safety profile. Trials of other anti-IL-23 agents in UC are under way and designed to explore head-to-head efficacy with existing biologics, as well as the prospect of combination biological therapy. Apart from data on longer term efficacy and safety, future trials should also explore strategies to inform the positioning of IL-23 antagonists in therapeutic algorithms.

中文翻译：

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抗白介素23剂，用于治疗溃疡性结肠炎。

简介：溃疡性结肠炎（UC）的治疗旨在控制症状并抑制肠道炎症。尽管取得了相当大的进步，但是仍有一部分患者对目前可用的药物没有反应。白介素（IL）-23轴在UC的发病机理中起着重要作用，因此已成为药物开发的重要靶标。研究范围：本综述简要概述了IL-12 / 23轴的病理生理学，并提供了一个摘要。 UC中乌斯替单抗，米立单抗（LY3074828），利桑基单抗（BI655066 / ABBV066），brazikumab（MEDI2070；以前为AMG139）和guselkumab（CNTO1959）的有效性和安全性的可用证据。我们还概述了该领域正在进行的和预期的试验。专家意见：mirikizumab的2期试验和ustekinumab的3期试验已证明抗IL-23药物在UC中实现临床和内镜预后的有效性，且安全性良好。UC中其他抗IL-23药物的试验正在进行中，旨在探索与现有生物制剂的头对头功效，以及联合生物疗法的前景。除了有关长期疗效和安全性的数据外，未来的试验还应该探索一些策略，以指导IL-23拮抗剂在治疗算法中的定位。