ArticleClinical journal of gastroenterology2026
Histopathological predictor of response to mirikizumab in active ulcerative colitis.
Article in Clinical journal of gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This case series reports three patients with active ulcerative colitis (UC) successfully treated with mirikizumab, a selective IL-23p19 monoclonal antibody. Mirikizumab was initiated based on both clinical presentation and a histopathological marker-high neutrophilic infiltration of the colonic epithelium classified as Geboes Grade 3.2-which reflects an IL-23/Th17-driven inflammatory phenotype. The cases included: an elderly man with acute severe pancolitis and primary nonresponse to infliximab; a middle-aged woman with steroid-dependent left-sided UC and inadequate response to adalimumab and ustekinumab; and a young biologic-naïve woman with steroid-refractory UC and bowel urgency. All three patients demonstrated high epithelial neutrophilic infiltration (Geboes Grade 3.2). These cases demonstrate the potential utility of histology-guided biologic selection and support Geboes Grade 3.2 as a candidate predictive biomarker for IL-23 inhibitor response in UC.
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