Lilly's mirikizumab, once a contender for psoriasis, bolsters case for UC indication in maintenance trial data readout
Early last year, Eli Lilly announced that instead of taking its blockbuster contender mirikizumab forward to the FDA for psoriasis, it would be essentially going nowhere in the indication. Instead, the pharma then announced in its Q1 ’21 earnings statement that it would be focusing on ulcerative colitis and Crohn’s disease indications in a sudden about-face.
And as the drug is before the FDA for potential approval for the first indication of ulcerative colitis, the megapharma is now ready to reveal more data to bolster its case.

The company announced a data readout early Tuesday morning for the Lucent-2 study after 52 weeks. While it announced last December that both primary and secondary endpoints were met in the study, Lilly waited until this week to release more specifics — and the numbers.
The trial, which enrolled patients with ulcerative colitis — those who had originally responded to mirikizumab in the previous study, a 12-week study simply known as Lucent-1 — reached the primary endpoint and all secondary endpoints in the maintenance trial.
According to Lilly, the primary endpoint was clinical remission, with just shy of 50% of participants in the mirikizumab arm reaching the goal compared to 25% on placebo. Clocking in a p-value of under 0.001, 182 of 365 patients in the mirikizumab arm reached the primary endpoint compared to only 45 of the 179 patients in placebo. For those who had already reached clinical remission by week 12, 63% — or 91 out of 143 in the treatment arm — maintained clinical remission through the rest of the trial.
Lilly noted that all but four patients who achieved remission after one year were no longer taking corticosteroids for at least three months prior to the end of maintenance treatment. Corticosteroids have been used as a common short-term treatment for ulcerative colitis because of its ability to reduce inflammation.
For secondary endpoints, bowel urgency severity was one of the more notable ones, Lilly’s VP of global immunology development and medical affairs Lotus Mallbris told Endpoints News. One of the trial investigators, Marla Dubinsky from the Icahn School of Medicine at Mount Sinai, said in a statement that 40% of mirikizumab patients achieved resolution or near resolution of their symptom of bowel urgency.
“We did another study that showed the highest symptom that bothers patients is bowel urgency,” Mallbris said. As part of the Lucent-2 study, patients were directed to a 11-point scale — ranging from 0 to 10, higher being more severe — to assess changes in the severity of their bowel urgency symptoms. And according to the data:
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Among patients who achieved clinical response in the 12-week induction study and who had a baseline urgency severity of 3 or greater, 42.9% of participants on mirikizumab (144 out of 336) achieved resolution or near resolution of bowel urgency severity at one year compared to one in four on placebo — also scoring a p-value of under 0.001.
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Among patients who achieved clinical response in the 12-week induction study, patients receiving mirikizumab had a statistically significant average reduction in bowel urgency severity of 3.80 points — between 3.53 and 4.07 at one year, compared to 2.74 (2.35 to 3.14) points for patients on placebo, with the same p-value of under 0.001.
The drug is a newer type of therapy — still part of the family of IL-23 inhibitors, but going after a subtype of IL-23: IL-23p19. Other already-approved IL-23 inhibitors would be IL-23p40 inhibitors. While other drugs have been already approved for ulcerative colitis such as Zeposia from Bristol Myers Squibb, it would be a new mechanism of action akin to the already-approved Skyrizi, the AbbVie-Boehringer Ingelheim drug that is still waiting for an ulcerative colitis approval. As of February, the FDA extended Skyrizi’s PDUFA date for Crohn’s disease by three months in order to review additional data.
As for what’s next for Eli Lilly, the pharma had already submitted a BLA for the drug candidate back in Q1 with the FDA — and also an MAA with the EMA. These new data have already been sent to the regulatory agencies in question, Mallbris said. And for right now, Lilly is expecting an answer from those agencies sometime next year.