Mirikizumab enhances life quality, productivity of patients with CD

The use of mirikizumab has improved work productivity and health-related quality of life (HRQoL) in patients with moderately to severely active Crohn’s disease (CD) by week 12, a study has shown. These improvements have been maintained for a year.

“In the phase III VIVID-1 study, treatment with mirikizumab resulted in significant and clinically meaningful improvements in HRQoL and work productivity compared with placebo up to 52 weeks in patients with moderately to severely active CD,” the researchers said.

VIVID-1 randomly allocated eligible patients to receive either mirikizumab (n=579) or placebo (n=199). Using the Inflammatory Bowel Disease Questionnaire (IBDQ), Short Form-36 Health Survey (SF-36), EQ-5D-5L visual analogue scale, and Work Productivity and Activity Impairment: CD measures, the researchers assessed the effects of mirikizumab on HRQoL at weeks 12 and 52.

For treatment comparisons, the researchers used the Cochran-Mantel-Haenszel test with nonresponder imputation (binary endpoints) and analysis of covariance with modified baseline observation carried forward (continuous endpoints).

Compared with placebo, mirikizumab use resulted in greater improvements in the mean change from baseline to weeks 12 and 52 in IBDQ total and domain scores, SF-36 summary and domain scores, and EQ-5D-5L visual analogue scale scores (p<0.001 for all). [Am J Gastroenterol 2025;120:1809-1819]

Work productivity

Furthermore, treatment with mirikizumab significantly improved Work Productivity and Activity Impairment: CD scores at week 12: absenteeism (p=0.001), presenteeism (p=0.005), activity impairment (p<0.001), and overall work impairment (p=0.002). These improvements persisted until week 52 (p<0.001 for all, except absenteeism).

At weeks 12 and 52, significantly more patients treated with mirikizumab vs placebo achieved IBDQ response, IBDQ remission, and clinically important improvements in the physical and mental component summaries of SF-36 (p<0.001 for all).

“Improvements were observed in disease-specific and generic HRQoL outcomes and work productivity at week 12 and were generally sustained, or further increased, at week 52,” the researchers said.

“These results are consistent with the primary results of VIVID-1, which show that mirikizumab is an effective therapeutic option for … moderately to severely active CD [as seen] through improvements in outcomes, such as mucosal inflammation, abdominal pain, stool frequency, fatigue, and bowel urgency,” they added. [J Crohns Colitis 2024;18(Suppl 1):i7-i9; J Crohns Colitis 2024;18(Suppl 1):i21-i23]

Limitations

Results of the VIVID-1 study may not be generalizable to patients in clinical practice, according to the researchers. Furthermore, the duration of the study may not fully capture the long-term effects of mirikizumab on HRQoL. Finally, validated generic and disease-specific instruments were used, but none assessed the mental well-being of patients with CD specifically.

“Future studies could include specific psychological assessments, such as evaluation of anxiety and depression, to offer further understanding of the relationship between mental health and quality-of-life outcomes associated with treatment in CD,” the researchers said.

“The chronic, debilitating nature of CD affects patients' physical, mental, and emotional well-being, which makes the improvement of HRQoL an important treatment goal for patients with CD,” they noted.