Omvoh (Mirikizumab)

Omvoh is a selective interleukin‑23 (IL‑23) inhibitor used in inflammatory bowel disease management.

• Ulcerative colitis: reduces signs and symptoms, achieving clinical remission in many patients.
• Crohn’s disease (investigational): evaluated for induction of remission in clinical trials.
• Pouchitis: studied as a potential therapy for inflammation of the ileal pouch.
• Rheumatoid arthritis (exploratory): assessed in early‑phase studies for disease activity reduction.

• Mirikizumab binds selectively to the p19 subunit of interleukin‑23, blocking its interaction with the IL‑23 receptor. This inhibition prevents downstream activation of the JAK‑STAT signaling cascade, reducing the production of pro‑inflammatory cytokines such as IL‑17 and IL‑22, and thereby modulating the immune response that drives chronic intestinal inflammation.

Adverse reactions reported with mirikizumab are generally mild to moderate, but serious events can occur.

Common Side Effects

• Injection site reactions: redness, swelling, or pain at the infusion site.
• Upper respiratory tract infection: nasopharyngitis or mild sinusitis.
• Headache: transient and often mild.
• Fatigue: general feeling of tiredness.
• Nausea: occasional mild gastrointestinal upset.
• Diarrhea: loose stools without infection.

Serious or Rare Side Effects

• Severe infections: including opportunistic bacterial, fungal or viral infections.
• Hypersensitivity reactions: anaphylaxis, urticaria, or angioedema.
• Hepatotoxicity: elevated liver enzymes indicating liver stress.
• Inflammatory bowel disease flare: paradoxical worsening of disease activity.
• Malignancy risk: potential increased risk of certain cancers with long‑term immunosuppression.
• Cardiovascular events: rare cases of myocardial infarction or stroke.

When prescribing mirikizumab, clinicians should assess patient history and monitor for specific safety concerns.

• Infection screening: evaluate for active or latent infections before initiation.
• Vaccination status: update vaccines, avoiding live vaccines during therapy.
• Liver function: monitor transaminases and bilirubin periodically.
• Gastrointestinal monitoring: watch for signs of disease flare or new abdominal symptoms.
• Pregnancy and lactation: weigh potential benefits against unknown fetal risks.
• Store at 2‑8 °C: keep refrigerated, protect from light, do not freeze or shake.

Mirikizumab may interact with other agents that affect immune function or infection risk.

Major Interactions (Avoid)

• Live vaccines: concurrent administration can cause severe infection.
• Systemic immunosuppressants (e.g., high‑dose corticosteroids): may amplify infection risk.

Moderate Interactions (Monitor Closely)

• Antifungal agents (e.g., azoles): may require infection surveillance.
• Antiviral therapies (e.g., hepatitis B prophylaxis): monitor viral load.
• Antibiotics: use judiciously, observing for opportunistic infections.