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mirikizumab + LY4395089 is an investigational combination therapy being developed by Eli Lilly and Company for the treatment of moderately to severely active Crohn's disease. The combination consists of mirikizumab (LY3074828), a humanized IgG4 monoclonal antibody that selectively targets the p19 subunit of interleukin-23 (IL-23), and LY4395089, an oral small-molecule farnesoid X receptor (FXR) agonist. By combining the systemic anti-inflammatory effects of IL-23 inhibition with the localized gut-protective and anti-inflammatory actions of FXR activation, this regimen aims to enhance mucosal healing and clinical remission rates. The combination is currently being evaluated in a Phase 2 clinical trial (NCT07483099) where patients receive intravenous mirikizumab co-administered with oral LY4395089, followed by subcutaneous mirikizumab maintenance therapy.
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