The European Commission has granted approval for Johnson & Johnson's Stelara (ustekinumab) for the treatment of adults with moderately-to-severely active ulcerative colitis (UC), marking a significant advancement in inflammatory bowel disease therapy. This approval makes Stelara the first interleukin-12/23 inhibitor authorized for UC treatment in Europe.
The new indication addresses a critical unmet need in UC treatment, where up to two-thirds of patients fail to respond adequately to current therapeutic options. Approximately 2.6 million people in Europe suffer from UC, a chronic inflammatory bowel condition that significantly impacts quality of life.
Clinical Trial Results Support Approval
The approval is based on compelling data from the phase 3 UNIFI study. The trial demonstrated that Stelara achieved clinical remission in approximately 16% of patients who had previously failed or could not tolerate other biological therapies, including TNF inhibitors or Takeda's Entyvio (vedolizumab). This response rate significantly exceeded the 5% remission rate observed in the placebo group.
Market Position and Commercial Impact
Stelara has maintained robust growth despite increasing competition, with sales reaching over $5 billion last year and showing a 23% increase to $2.96 billion in the first half of this year. This growth persists even as newer biologics, particularly IL-17 inhibitors like Novartis's Cosentyx and IL-23 inhibitors such as AbbVie's Skyrizi, have demonstrated superior efficacy in certain indications.
Competitive Landscape
The UC treatment space is becoming increasingly competitive. Stelara will compete with established treatments including Pfizer's Xeljanz (tofacitinib), an oral JAK inhibitor approved for moderate-to-severe UC. However, Xeljanz has faced safety concerns at higher doses. Additionally, newer therapies are in development, including Eli Lilly's experimental IL-23 inhibitor mirikizumab.
Market Outlook
While the UC approval represents a significant milestone for Stelara, market analysts at GlobalData project measured expectations for its adoption in this indication. They forecast that inflammatory bowel disease sales for Stelara will reach $1.5 billion by 2026 in top pharmaceutical markets, with the majority ($1.3 billion) coming from Crohn's disease rather than UC.
The approval for UC treatment adds to Stelara's existing indications for psoriasis, psoriatic arthritis, and Crohn's disease, further solidifying its position in the inflammatory disease market. Johnson & Johnson's Janssen unit continues to expand its inflammatory disease portfolio, with its selective IL-23 inhibitor Tremfya (guselkumab) also in late-stage testing for UC.
