Lilly’s LUCENT-3 showed ~78 % corticosteroid-free remission and 81 % endoscopic remission sustained through four years, while obefazimod and icotrokinra each delivered strong induction efficacy within 8–12 weeks. How do you interpret the trade-off between rapid onset and multi-year durability across these mechanisms?

We now have an IL-23 p19 antibody (mirikizumab), a once-daily oral IL-23 receptor blocker (icotrokinra), and an oral immune-modulator that amplifies regulatory micro-RNAs (obefazimod). What does this mechanistic diversity suggest about fine-tuning immune balance in UC, and could complementary or sequential use yield additive benefit?

Across studies, 27 % of mirikizumab’s long-term cohort and nearly 47 % of obefazimod participants had prior advanced-therapy failure, while icotrokinra’s induction response remained >30 % clinical remission even after multiple lines. How should we contextualize these outcomes for patients with refractory UC compared to first-line biologic-naïve cases?

Icotrokinra’s once-daily oral dosing contrasts with subcutaneous or intravenous regimens for mirikizumab and potential oral small-molecule competitors like obefazimod. From a health-system and patient-behavior perspective, how much could oral IL-23-targeting therapies shift adherence, persistence, and access dynamics in chronic UC management?

Mirikizumab’s LUCENT-3 data emphasized bowel-urgency relief (UNRS ≥ 3-point reduction in 93 %) and 90 % IBDQ remission, while obefazimod and icotrokinra improved symptomatic and endoscopic endpoints early. Are patient-reported outcomes becoming decisive in differentiating therapies once objective mucosal healing reaches parity?

Four years of mirikizumab show no new safety signals, obefazimod maintained tolerability at both 25 mg and 50 mg doses, and icotrokinra’s Phase 2b profile was comparable to placebo through 12 weeks. How should clinicians weigh long-term immunogenicity and infection risks when comparing a long-acting biologic to continuously dosed oral agents?

With Lilly’s established approvals, Abivax’s Phase 3 momentum, and Protagonist advancing toward Phase 3 and NDA pathways, what factors—durability data, oral formulation, safety consistency—will most influence payer adoption and guideline placement across regions?