Urgency. Behind this term hides many situations. For some, however, dealing with this word is almost a daily problem. Which perhaps leads to choosing a place to dine, studying first the availability of a toilet, which makes typical social relationships more difficult, which hides discomfort and suffering. And then urgency takes on a different connotation, becoming a daily travel companion.
We are talking, obviously, about intestinal urgency. Because this is a symptom often present in those who suffer from ulcerative colitisa disease that affects about 150,000 people in Italy and often appears at a young age. Together with the urgency, frequency of bowel movements and rectal bleeding can become symptoms that limit the quality of life.
It is no wonder, then, that research into solutions for the most complex cases continues. “Although most patients are initially diagnosed with mild disease and begin conventional therapy, many will progress to have moderate to severe active disease, which has a major impact on quality of life,” he explains. Alessandro Armuzzi, Head of the IBD Unit, Humanitas Clinical Institute, Rozzano and Full Professor of Gastroenterology, Humanitas University – Despite the availability of current treatments, there remains a significant need for new therapeutic options, able to address disruptive symptoms, such as bowel urgency.”
It is in this groove that a new treatment opportunity. Lilly has announced that the Italian Medicines Agency (AIFA) has approved the reimbursement of the first interleukin-23p19 (IL-23p19) antagonist – mirikizumab – for the treatment of moderately to severely active ulcerative colitis (UC) in adult patients.
Mirikizumab is the only drug currently reimbursed in Italy for ulcerative colitis to selectively target the p19 subunit of IL-23, which plays a crucial role in inflammation related to ulcerative colitis. A mechanism of action that allows us to offer relief from key symptoms such as bowel frequency, rectal bleeding, and bowel urgency, regardless of previous use of biologics.
“Mirikizumab, in addition to having demonstrated its efficacy in achieving relevant clinical objectives such as steroid-free remission at one year, is able to determine a rapid improvement in symptoms, such as rectal bleeding and evacuation frequency, already after three weeks” comments Max Claudio Fantinigeneral secretary of IG-IBD (Italian Group for the study of Inflammatory Bowel Disease) and full professor of Gastroenterology, University of Cagliari, Director of the Complex Structure of Gastroenterology, Aou of Cagliari. “In particular, the studies that led to the registration of the drug were the first and only ones to use a patient-centered assessment scale of intestinal urgency, recording a clear improvement in the symptom of urgency especially in those who respond best to induction therapy”.
Intestinal urgency, therefore, is increasingly becoming a target to evaluate the impact of a treatment. And science confirms it. The American College of Gastroenterology in its guidelines recognizes the importance of intestinal urgency as a major concern for patients living with the disease.
“The design of our clinical development program in this area, which also introduced the quantitative assessment of intestinal urgency, demonstrates Lilly’s ongoing commitment to innovation and to responding to patients’ health needs,” he concludes. Veronica Pray, Associate VP-Medical Italy Hub di Lilly – we are happy and proud to be able to collaborate with the entire scientific community that deals with these pathologies and to be able to make available to people with ulcerative colitis a new therapeutic opportunity capable of translating into a tangible improvement in their quality of life”.
In short, an additional opportunity for treatment. The treatment of ulcerative colitis is based on pharmacological therapy and, in the most serious cases, surgery. Today, several drugs are available with the indication to treat this pathology; their use depends on the general state of health of the patient and the severity of the symptoms. Anti-inflammatory drugs are often the first step in treatment. Then, there are drugs that act on inflammation by modulating the immune system, such as immunosuppressants, or on specific targets involved in the mechanisms that trigger and sustain inflammation itself.