Comparing the efficacy and safety of Mirikizumab and Etrasimod in treating moderate to severe ulcerative colitis and Crohn’s disease: A systematic review and meta-analysis

Background: Many IBD patients do not react to traditional or biological therapies. Research suggests that Mirikizumab and Etrasimod may be effective therapy options for these individuals. This research aimed to evaluate the efficacy and safety of utilizing Mirikizumab and Etrasimod to treat moderate to severe IBD, including Crohn's disease (CD) and ulcerative colitis.
Methods: We searched PubMed, Medline, Web of Science, Scopus, Cochrane Library, Embase, Google Scholar, CINAHL, Clinical Trials.gov, and WHO Trials Registry (ICTRP). We included RCTs that compared Mirikizumab and Etrasimod to placebo in patients with active CD or UC. The principal results were mucosal healing as well as the clinical response and remission throughout the induction and maintenance periods. The frequency of severe adverse events was the secondary outcome. Comprehensive Meta-analysis version 4 (Biostat Inc., USA) was utilized in the study.
Results: A total of Seventeen randomized controlled trials were included in the analysis. Of these, fourteen studies examined the effectiveness and safety of Mirikizumab and Etrasimod in patients with UC, while three research looked at same topics in patients with CD. In people with moderately to highly active CD or UC, the meta-analysis showed that both Mirikizumab and Etrasimod therapies were more effective than placebo in inducing clinical response and achieving clinical remission during the induction and maintenance stages of treatment. Interestingly, we discovered that for patients with UC but not CD, Mirikizumab was a better first-line therapy than Etrasimod.
Conclusion: Mirikizumab and Etrasimod are safe and effective treatments for patients with CD and UC. RCTs including a greater number of patients are still necessary, nevertheless, in order to more accurately evaluate the safety profile of Mirikizumab and Etrasimod.