Test Code MIRI Mirikizumab, Serum
Ordering Guidance
Therapeutic drug monitoring of mirikizumab may be useful when assessing response to therapy is difficult or when patients need to be above a certain therapeutic concentration to improve the odds of a clinical response for therapy optimization, dose increases, or de-escalation or discontinuation of therapy.
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.5 mL Serum
Collection Instructions:
1. Draw blood immediately before next scheduled dose (trough specimen).
2. Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial.
Useful For
Assessing the response to mirikizumab therapy
Assessing the need for dose escalation
Evaluating the potential for dose de-escalation or discontinuation of therapy
Monitoring patients who need to be above a certain mirikizumab concentration to improve the odds of a clinical response for therapy optimization
Method Name
Liquid Chromatography Mass Spectrometry (LC-MS)
Reporting Name
Mirikizumab, SSpecimen Type
SerumSpecimen Minimum Volume
Serum: 0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Serum | Refrigerated (preferred) | 28 days |
| Ambient | 28 days | |
| Frozen | 28 days |
Reference Values
Lower limit of quantitation = 0.5 mcg/mL
Interpretation
The optimal therapeutic concentration of mirikizumab associated with favorable outcomes in inflammatory bowel disease (IBD) is not known at this time. The recommendation is to use the lowest concentration that maintains response. Model-based analyses suggest steady-state trough concentrations of 1.5 to 3.0 mcg/mL, with peak concentrations of approximately 10 to 11 mcg/mL during subcutaneous maintenance dosing every-4 weeks in patients with IBD.
Therapeutic thresholds vary according to the disease, treatment regimen, and response or lack of response to therapy.
Clinical Reference
1. Omvoh (mirikizumab). Package insert. Eli Lilly and Company; 2023. Updated November 2025. Accessed March 9, 2026. Available at https://uspl.lilly.com/omvoh/omvoh.html?s=pi
2. Ladwig PM, Barnidge DR, Willrich MA. Quantification of the IgG2/4 kappa monoclonal therapeutic eculizumab from serum using isotype specific affinity purification and microflow LC-ESI-Q-TOF mass spectrometry. J Am Soc Mass Spectrom. 2017;28(5):811-817
3. Ladwig PM, Barnidge DR, Willrich MAV. Mass spectrometry approaches for identification and quantitation of therapeutic monoclonal antibodies in the clinical laboratory. Clin Vaccine Immunol. 2017;24(5):e00545-16
4. Chua L, Friedrich S, Zhang XC. Mirikizumab pharmacokinetics in patients with moderately to severely active ulcerative colitis: Results from phase III LUCENT studies. Clin Pharmacokinet. 2023;62(10):1479-1491. doi:10.1007/s40262-023-01281-z
5. Kobayashi T, Matsuoka K, Watanabe M, et al. Efficacy and safety of mirikizumab as induction and maintenance therapy for Japanese patients with moderately to severely active ulcerative colitis: a subgroup analysis of the global phase 3 LUCENT-1 and LUCENT-2 studies. Intest Res. 2024;22(2):172-185. doi:10.5217/ir.2023.00043
6. Aslam M, Ali MH, Irfan H. Mirikizumab: A promising breakthrough in Crohn's disease treatment. Health Sci Rep. 2024;7(8):e2294. doi:10.1002/hsr2.2294
Day(s) Performed
Wednesday
Report Available
2 to 9 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
80299
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MIRI | Mirikizumab, S | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 623669 | Mirikizumab, S | In Process |
Testing Algorithm
For information see Ulcerative Colitis and Crohn Disease Therapeutic Drug Monitoring Algorithm.