New Release: Alpha testing version has been released.

Risankizumab

L04A - Immunosuppressants ATC L04AC18 Antibody approved 2019 Parenteral

JFDA label: Skyrizi

Mechanism of Action

Inhibitor of Interleukin-23 — Interleukin-23 inhibitor

TargetActionGene / 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

Very Common >10%Common 1–10%Uncommon 0.1–1% Rare 0.01–0.1%Very Rare <0.01%Not Known

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

For the treatment of Crohn’s disease and ulcerative colitis: Obtain liver enzymes and bilirubin levels prior to initiating treatment with SKYRIZI. ( 2.1 , 5.4 ) Complete all age-appropriate vaccinations as recommended by current immunization guidelines ( 2.1 , 5.5 ) Recommended Dosage Plaque Psoriasis and Psoriatic Arthritis: 150 mg administered by subcutaneous injection at Week 0, Week 4, and every 12 weeks thereafter. ( 2.3 , 2.4 ) In patients with psoriatic arthritis SKYRIZI can be administered alone or in combination with non-biologic disease-modifying antirheumatic drugs (DMARDs). ( 2.4 ) Crohn’s Disease: The recommended induction dosage is 600 mg administered by intravenous infusion over at least one hour at Week 0, Week 4, and Week 8. The recommended maintenance dosage is 180 mg or 360 mg administered by subcutaneous injection at Week 12, and every 8 weeks thereafter. Use the lowest effective dosage to maintain therapeutic response. ( 2.6 ) Ulcerative Colitis: The recommended induction dosage is 1,200 mg administered by intravenous infusion over at least two hours at Week 0, Week 4, and Week 8. The recommended maintenance dosage is 180 mg or 360 mg administered by subcutaneous injection at Week 12, and every 8 weeks thereafter. Use the lowest effective dosage to maintain therapeutic response. ( 2.7 ) 2.1 Procedures Prior to Treatment Initiation For the treatment of Crohn’s disease and ulcerative colitis, obtain liver enzymes and bilirubin levels prior to initiating treatment with SKYRIZI [see Warnings and Precautions ( 5.4 )] Evaluate patients for tuberculosis (TB) infection prior to initiating treatment with SKYRIZI [see Warnings and Precautions ( 5.3 )] . Complete all age-appropriate vaccinations as recommended by current immunization guidelines [see Warnings and Precautions ( 5.5 )]. 2.2 General Considerations for Administration • Visually inspect SKYRIZI for particulate matter and discoloration prior to administration. The solution may contain a few translucent to white particles. ○ SKYRIZI 150 mg/mL prefilled pen or prefilled syringe, 180 mg/1.2 mL prefilled syringe or prefilled cartridge, and 360 mg/2.4 mL prefilled cartridge: a colorless to yellow, and clear to slightly opalescent solution. ○ SKYRIZI 90 mg/mL prefilled syringe and 600 mg/10 mL vial: a colorless to slightly yellow, and clear to slightly opalescent solution. ○ Do not use if the solution contains large particles or is cloudy or discolored. • Discard after use. Do not reuse. 2. 3 Recommended Dosage for Plaque Psoriasis The recommended dosage is 150 mg administered by subcutaneous injection at Week 0, Week 4, and every 12 weeks thereafter. 2. 4 Recommended Dosage for Psoriatic Arthritis The recommended dosage is 150 mg administered by subcutaneous injection at Week 0, Week 4, and every 12 weeks thereafter. SKYRIZI may be administered alone or in combination with non-biologic disease-modifying antirheumatic drugs (DMARDs). 2. 5 Preparation and Administration Instruction s (Plaque Psoriasis and Psoriatic Arthritis) Administer SKYRIZI 150 mg/mL prefilled pen or prefilled syringe subcutaneously. Patients may self-inject SKYRIZI after training in subcutaneous injection technique. Provide proper training to patients and/or caregivers on the subcutaneous injection technique of SKYRIZI. Before injecting, remove the carton with SKYRIZI from the refrigerator and without removing the prefilled pen or prefilled syringe from the carton, allow SKYRIZI to reach room temperature out of direct sunlight (30 to 90 minutes for the prefilled pen and 15 to 30 minutes for the prefilled syringe). Do not inject into areas where the skin is tender, bruised, erythematous, indurated or affected by psoriasis. Administration of SKYRIZI in the upper, outer arm may only be performed by a healthcare professional or caregiver. If a dose is missed, administer the dose as soon as possible. Thereafter, resume dosing at the regular scheduled time. The SKYRIZI “Instructions for Use” contai

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 Data Hale L3

No information is available on the clinical use of risankizumab during breastfeeding.

Biology & Pharmacokinetics

Drug–drug interactions (78, DDInter)

Interacting drugSeverityManagement
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)

BrandForm / strengthPackAgentCitizen (JOD)
Skyrizi Pre-filled Pen 150 mg/1 ml 1 PFP Abu Sheikha Drug Store