Long-term Outcomes of Patients with Crohn’s Disease Treated with Risankizumab

1. In adult patients with Crohn’s disease (CD) treated with risankizumab, only 13% of patients experienced treatment failure while 23% of patients required treatment escalation.

2. Treatment failure with risankizumab was associated with penetrating CD 

Evidence Rating Level: 2 (Good)

Risankizumab is a newer therapeutic option approved for the management of CD, with a previous randomized clinical trial demonstrating superior efficacy compared to ustekinumab with regards to endoscopic remission at 48 weeks. However, there is a lack of data from real-world studies regarding the effectiveness of risankizumab. This retrospective cohort study therefore sought to investigate the real-world effectiveness of risankizumab in the management of CD. 106 patients (median[QR] age, 25.5[19-38] years; 50% male) from a single tertiary centre in the United States were included in this study. 13% of patients (14/106) experienced treatment failure, with penetrating CD being found during multivariate analysis to be associated with treatment failure (HR, 5.2; 95% CI, 1.6-17.2; P = .007). 23% of patients (24/106) required treatment escalation, with perianal fistulizing CD (HR, 3.3; 95% CI, 1.2-9.4; P = .023) and prior exposure to more than 2 biologics (HR, 5.8; 95% CI, 1.3-26.3; P = .022) as variables associated with treatment escalation under multivariate analysis. Overall, this study found that risankizumab is an effective treatment option in the management of CD, with few patients experiencing treatment failure. 

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