Risankizumab
JFDA label: Skyrizi
Mechanism of Action
Inhibitor of Interleukin-23 — Interleukin-23 inhibitor
| Target | Action | Gene / class |
|---|---|---|
| Interleukin-23 efficacy | INHIBITOR |
Indications
Approved
- Arthritis, Psoriatic — psoriatic arthritis
- Immune System Diseases — immune system disease
- Psoriasis — psoriasis
Off-label
- Arthritis, Juvenile
- Asthma
- Colitis, Ulcerative
- Crohn Disease
- Dermatitis
- Hidradenitis Suppurativa
- Severe Acute Respiratory Syndrome
- Spondylitis, Ankylosing
Contraindications
Source: openFDA
- is contraindicated in patients with a history of serious hypersensitivity reaction to risankizumab-rzaa or any of the excipients [see Warnings and Precautions ( 5.1 )] . SKYRIZI is contraindicated in patients with a history of serious hypersensitivity reaction to risankizumab-rzaa or any of the excipients ( 4 ) Absolute
Adverse Reactions
Nervous system disorders (1)
Common Headache
Gastrointestinal disorders (1)
Common Abdominal Pain
Musculoskeletal and connective tissue disorders (1)
Common And Arthralgia 6 1 Maintenance Arthralgia
General disorders and administration site conditions (2)
Common Fatigue · Injection Site Reactions
Dosing
Source: openFDA
Warnings & Precautions
Source: openFDA
Warnings & Precautions
Hypersensitivity Reactions: Serious hypersensitivity reactions, including anaphylaxis, may occur. ( 5.1 ) Infections: SKYRIZI may increase the risk of infection. Instruct patients to seek medical advice if signs or symptoms of clinically important infection occur. If such an infection develops, do not administer SKYRIZI until the infection resolves. ( 5.2 ) Tuberculosis (TB): Evaluate for TB prior to initiating treatment with SKYRIZI. ( 5.3 ) Hepatotoxicity in Treatment of Inflammatory Bowel Disease: Drug-induced liver injury during induction has been reported. Monitor liver enzymes and bilirubin levels at baseline and, during induction, up to at least 12 weeks of treatment. Monitor thereafter according to routine patient management. ( 5.4 ) Administration of Vaccines: Avoid use of live vaccines. ( 5.5 )
Hypersensitivity Reactions Serious hypersensitivity reactions, includi
Hypersensitivity Reactions Serious hypersensitivity reactions, including anaphylaxis, have been reported with use of SKYRIZI. If a serious hypersensitivity reaction occurs, discontinue SKYRIZI and initiate appropriate therapy immediately [see Adverse Reactions ( 6.1 )]. 5. 2 Infections SKYRIZI may increase the risk of infections [see Adverse Reactions ( 6.1 )] . Treatment with SKYRIZI should not be initiated in patients with any clinically important active infection until the infection resolves or is adequately treated. In patients with a chronic infection or a history of recurrent infection, consider the risks and benefits prior to prescribing SKYRIZI. Instruct patients to seek medical advice if signs or symptoms of clinically important infection occur. If a patient develops such an infection or is not responding to standard therapy, monitor the patient closely and do not administer SKYRIZI until the infection resolves. 5. 3 Tuberculosis Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with SKYRIZI. Across the Phase 3 psoriasis clinical studies, of the 72 subjects with latent TB who were concurrently treated with SKYRIZI and appropriate TB prophylaxis during the studies, none developed active TB during the mean follow-up of 61 weeks on SKYRIZI. Two subjects taking isoniazid for treatment of latent TB discontinued treatment due to liver injury. Of the 31 subjects from the PsO-3 study with latent TB who did not receive prophylaxis during the study, none developed active TB during the mean follow-up of 55 weeks on SKYRIZI. Consider anti-TB therapy prior to initiating SKYRIZI in patients with a past history of latent or active TB in whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after SKYRIZI treatment. Do not administer SKYRIZI to patients with active TB. 5. 4 Hepatotoxicity in Treatment of Inflammatory Bowel Disease A serious adverse reaction of drug-induced liver injury in conjunction with a rash that required hospitalization was reported in a patient with Crohn’s disease (ALT 54x ULN, AST 30x ULN, and total bilirubin 2.2x ULN) following two 600 mg intravenous doses of SKYRIZI. The liver test abnormalities resolved following administration of steroids. SKYRIZI was subsequently discontinued. For the treatment of Crohn’s disease and ulcerative colitis, evaluate liver enzymes and bilirubin at baseline, and during induction at least up to 12 weeks of treat
Administration of Vaccines Avoid use of live vaccines in patients trea
Administration of Vaccines Avoid use of live vaccines in patients treated with SKYRIZI. Medications that interact with the immune system may increase the risk of infection following administration of live vaccines. Prior to initiating therapy with SKYRIZI, complete all age-appropriate vaccinations according to current immunization guidelines. No data are available on the response to live or inactive vaccines.
Pregnancy & Lactation
Lactation
No information is available on the clinical use of risankizumab during breastfeeding.
Biology & Pharmacokinetics
Drug–drug interactions (78, DDInter)
| Interacting drug | Severity | Management |
|---|---|---|
| Adalimumab | major | |
| Bacillus calmette-guerin substrain tice live antigen | major | |
| Baricitinib | major | |
| Certolizumab pegol | major | |
| Cladribine | major | |
| Etanercept | major | |
| Fingolimod | major | |
| Golimumab | major | |
| Infliximab | major | |
| Leflunomide | major | |
| Measles virus vaccine live attenuated | major | |
| Mumps virus strain B level jeryl lynn live antigen | major | |
| Natalizumab | major | |
| Ozanimod | major | |
| Rotavirus vaccine | major | |
| Rubella virus vaccine | major | |
| Siponimod | major | |
| Smallpox (Vaccinia) Vaccine, Live | major | |
| Talimogene laherparepvec | major | |
| Teriflunomide | major | |
| Tofacitinib | major | |
| Typhoid vaccine (live) | major | |
| Upadacitinib | major | |
| Varicella Zoster Vaccine (Recombinant) | major | |
| Yellow Fever Vaccine | major | |
| Alefacept | moderate | |
| Alemtuzumab | moderate | |
| Anakinra | moderate | |
| Anthrax vaccine | moderate | |
| Azathioprine | moderate | |
| Bifidobacterium longum infantis | moderate | |
| Canakinumab | moderate | |
| Candida albicans | moderate | |
| Clostridium tetani toxoid antigen (formaldehyde inactivated) | moderate | |
| Coccidioides immitis spherule | moderate | |
| Cyclosporine | moderate | |
| Denosumab | moderate | |
| Dimethyl fumarate | moderate | |
| Diroximel fumarate | moderate | |
| Efalizumab | moderate |
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Registered Products (1)
| Brand | Form / strength | Pack | Agent | Citizen (JOD) |
|---|---|---|---|---|
| Skyrizi | Pre-filled Pen 150 mg/1 ml | 1 PFP | Abu Sheikha Drug Store | — |