Risankizumab
Interleukin inhibitors
Interleukin inhibitors
A humanised antibody against the p19 subunit of interleukin-23 for plaque psoriasis, psoriatic arthritis, Crohn's disease and ulcerative colitis.
Quick facts
- Group
- Interleukin inhibitors
- Target
- Interleukin-23, p19 subunit (IL-23p19)
- Used for
- Moderate to severe plaque psoriasis · Crohn's disease
- Key effects
- Upper respiratory infections · Headache and tiredness
- Monitor
- Latent tuberculosis test before starting
- ATC
- L04AC18
No doses: the clinician sets them by the current guideline.
Mechanism of action
Risankizumab is a humanised IgG1 monoclonal antibody against the p19 subunit of interleukin-23. Without IL-23, Th17 cells are not maintained and make less IL-17, so skin, joint and bowel inflammation fall. It has a longer half-life than guselkumab, so maintenance injections are spaced further apart.
- Antibody binds the p19 subunit of IL-23
- Th17 cells lose their survival signal
- Less IL-17 and related cytokines
- Skin, joint and bowel inflammation settles
Indications
- Moderate to severe plaque psoriasis Psoriasis →
- Psoriatic arthritis Psoriatic arthritis →
- Crohn's disease Crohn disease →
- Ulcerative colitis Ulcerative colitis →
Adverse effects
Common
- Upper respiratory infections, sore throat, runny nose
- Headache and tiredness
- Injection-site reactions
- Joint or back pain
Contraindications
- Hypersensitivity to risankizumab
- Active serious infection, including active tuberculosis
Key interactions
- Live vaccines
- Avoided during treatment; age-appropriate vaccines are given before starting.
- Other immunosuppressants and biologics
- Added infection risk.
What is monitored
- Latent tuberculosis test before starting
- Liver tests before and during treatment
- Signs of infection
Administration and safety
- Intravenous doses are given in a clinic; the first subcutaneous dose may also be given there.
- Subcutaneous doses can be given at home after teaching (syringe, pen or on-body injector).
- Vaccines are brought up to date before starting.
Pregnancy and breastfeeding
Human data are limited; pregnancy and breastfeeding are discussed with the treating team.
Nursing care
- Confirm the tuberculosis test and ask about liver disease, including cirrhosis.
- Teach to report yellow skin or eyes, dark urine, nausea or upper right abdominal pain.
- Teach to report fever, persistent cough, weight loss or night sweats.
Pharmacokinetics
- Absorption
- Subcutaneous injection; an intravenous form also exists
- Half-life
- Longer than guselkumab's, allowing more widely spaced maintenance doses
Test yourself
Think of the answer, then tap the question to see it.
Which subunit of IL-23 does risankizumab bind?
The p19 subunit.
Which laboratory tests are watched during risankizumab treatment?
Liver tests, because of possible liver injury.
Which two IL-23 p19 antibodies are used in both psoriasis and inflammatory bowel disease?
Guselkumab and risankizumab.
Connections
← Back to the class: Interleukin inhibitors
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Risankizumab-rzaa Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.