On October 20, 2022, Health Canada granted approval for SKYRIZI® (risankizumab) as the latest addition for the treatment of moderate-severe Crohn’s disease. SKYRIZI® has been used for the treatment of moderate to severe psoriasis and recently gained approval for psoriatic arthritis. It is a protein-based medication known as a biologic and therefore must be given by infusion or injection to avoid stomach digestion. The approved dose for Crohn’s disease is 600 mg as an infusion at Week 0, Week 4, and Week 8, followed by 360 mg as a subcutaneous (just below the skin) injection 4 weeks later. Maintenance doses are given every 8 weeks thereafter as an injection.
There are many effective biologic therapies approved for Crohn’s disease. Some reduce a specific inflammatory chemical called TNF (Tumor Necrosis Factor) which is made in excess in the gut (e.g., adalimumab/Humira and biosimilars, infliximab/Remicade and biosimilars, golimumab/Simponi). Another type of biologic called vedolizumab (Entyvio) prevents immune cells (T-cells) from moving into the gut lining. Ustekinumab (Stelara) is another biologic agent that is used to treat Crohn’s by reducing the excess signaling to the immune system by blocking the signaling substances interleukin-12 (IL-12) and interleukin-23 (IL23). In contrast, Risankizumab (Skyrizi) provides a much more targeted approach than ustekinumab (Stelara) by blocking only IL-23 instead of both IL-12 and IL-23.
The great news is that our tool chest is expanding for the treatment of this autoimmune disease! This a welcome addition to treatment as we recognize November as Crohn’s and Colitis month.
Carolyn Whiskin is the Pharmacy Manager for Charlton Health. Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain, and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.
Kunal Bhatt, RPh, PharmD, HBSc is a staff pharmacist for Charlton Health. As a 2020 PharmD graduate from the University of Toronto, Kunal possesses a diverse range of experiences from working in hospital and community pharmacy settings. Since January 2021, Kunal was heavily invested in contributing to the efforts against COVID-19 by administering upwards of 5000 COVID-19 vaccines at William Osler Health System’s vaccination clinics.