Skyrizi

Skyrizi (risankizumab) is a biologic injection approved for moderate-to-severe plaque psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis. It belongs to a class of drugs called IL-23 inhibitors that precisely target a key driver of these inflammatory conditions. Since its first approval in 2019 for plaque psoriasis, Skyrizi has expanded its indications and become a leading treatment option for several immune-mediated diseases.

Skyrizi belongs to the IL-23 Inhibitors class of medications. Risankizumab is a humanized IgG1 monoclonal antibody that selectively binds the p19 subunit of interleukin-23 (IL-23), blocking downstream inflammatory signaling that drives psoriasis, Crohn's disease, and ulcerative colitis. Understanding how Skyrizi works helps explain both its therapeutic benefits and its characteristic side-effect profile.

## What Skyrizi is used for

Skyrizi is prescribed for Moderate-to-severe plaque psoriasis, Psoriatic arthritis, Crohn's disease, and Ulcerative colitis. For psoriasis, Skyrizi is used in adults whose disease has not responded adequately to topical therapies. For Crohn's disease and ulcerative colitis, it is used in adults with moderately-to-severely active disease. Skyrizi is available by prescription only and has been FDA-authorized since 2019.

## Dosage and administration

Typical adult dosing: Plaque psoriasis: 150 mg SC at weeks 0, 4, then every 12 weeks. Crohn's/UC: 600 mg IV induction at weeks 0, 4, 8; then 360 mg SC every 8 weeks maintenance.

For plaque psoriasis and psoriatic arthritis, Skyrizi is given as a subcutaneous injection every 12 weeks after two initial doses four weeks apart. For Crohn's disease and ulcerative colitis, treatment begins with three intravenous infusions over eight weeks (induction), then switches to subcutaneous maintenance injections every eight weeks. Never change your dose or stop Skyrizi without speaking to your prescriber. Available forms include Subcutaneous injection (prefilled pen or syringe) and Intravenous infusion (Crohn's/UC induction).

## Side effects

Like all medicines, Skyrizi can cause side effects, though many people tolerate it well. Common side effects include Upper respiratory infections, Injection-site reactions, Headache, Fatigue, and Tinea infections. Serious side effects that warrant prompt medical attention include Serious infections, Tuberculosis reactivation, Hypersensitivity reactions, and Inflammatory bowel disease flare (in psoriasis patients). The most common side effects are infections of the upper respiratory tract. Because Skyrizi modulates the immune system, there is a risk of serious infections including reactivation of latent tuberculosis. Seek emergency care for signs of a severe allergic reaction — hives, swelling of the face or throat, or difficulty breathing.

## Managing common side effects

Many of the common effects of Skyrizi can be managed with simple self-care:

• Upper respiratory infections: rest, stay hydrated, and contact your clinician if symptoms worsen or last more than two weeks.
• Injection-site reactions: rotate injection sites and allow the pen to reach room temperature before injecting.
• Headache: stay hydrated, rest, and use a simple analgesic if your clinician agrees it is safe for you.
• Fatigue: prioritize rest and maintain a consistent sleep schedule; report persistent fatigue to your clinician.
• Tinea infections: maintain good skin hygiene; antifungal treatment may be needed if a fungal skin infection develops.

## Warnings and precautions

Before starting Skyrizi, tell your healthcare provider about all your medical conditions. Key precautions: Screen and treat latent TB before starting Skyrizi; Monitor for infections during treatment; Do not administer live vaccines while on Skyrizi. Skyrizi is not suitable for everyone — active serious infections are a contraindication.

## Drug interactions

Skyrizi can interact with Live vaccines (major) — avoid live vaccines during and shortly after Skyrizi treatment; Other immunosuppressants (moderate) — concurrent use increases risk of serious infection. Keep an up-to-date medication list and have your pharmacist run an interaction check whenever a new drug is added.

## Cost, coverage, and savings

Skyrizi has a list price of approximately $60,000–$80,000 per year. AbbVie, the manufacturer, offers a savings card for commercially insured patients that can reduce costs substantially. Patients may also qualify for the myAbbVie Assist patient assistance program if they lack insurance or meet income requirements. Searching for a skyrizi copay card, skyrizi savings card, or skyrizi patient assistance through the manufacturer's official website is the most reliable path to cost support.

## How Skyrizi compares to alternatives

Skyrizi is one of the newer IL-23 inhibitors, along with Tremfya (guselkumab) and Ilumya (tildrakizumab). It differs from Stelara (which blocks both IL-12 and IL-23) by selectively targeting only IL-23. Compared to older TNF inhibitors like Humira, Skyrizi generally shows higher skin clearance rates in psoriasis trials. For Crohn's disease, comparative data with other biologics continue to accumulate. The best biologic for any individual depends on the specific condition, prior treatment history, insurance coverage, and preferences around dosing schedule.

## Monitoring and lifestyle

Before starting Skyrizi, TB screening is required. During treatment, clinicians watch for signs of infection, monitor disease activity, and periodically assess the need to continue. A healthy lifestyle, adequate sleep, stress management, and avoiding smoking all support better inflammatory disease outcomes. Keep scheduled appointments so your clinician can confirm Skyrizi is working and catch any problems early.

## What to expect from treatment

For plaque psoriasis, significant skin clearance often begins within 4–8 weeks, with many patients achieving near-complete or complete clearance by week 16. For Crohn's disease and ulcerative colitis, clinical response during the induction phase guides decisions about maintenance. Success is measured against your personal treatment goals — whether that is clear skin, reduced joint pain, or achieving remission from bowel disease.

## Before you start Skyrizi

A thorough pre-treatment review includes TB skin test or IGRA blood test, checking for active infections, reviewing vaccination history, and discussing pregnancy plans. Bring a complete list of prescription drugs, over-the-counter products, vitamins, and herbal supplements so interactions can be screened.

## Missed dose and overdose

If you miss a Skyrizi injection, administer it as soon as you remember and then resume your regular schedule from that date. If you suspect an overdose, contact your local poison control center or emergency services immediately.

## Use in specific populations

Pregnancy and breastfeeding: Use with caution; data are limited, and the risks should be discussed with your clinician. Older adults may be at higher risk for infections. Pediatric use is not established for Crohn's or UC; a pediatric indication exists for plaque psoriasis in patients 6 and older.

## When to contact your doctor

Contact your healthcare provider if you develop signs of infection (fever, chills, cough, wounds that won't heal), worsening of your underlying condition, or new symptoms after starting Skyrizi. Call emergency services for chest pain, trouble breathing, or signs of a serious allergic reaction.

## Storage and handling

Refrigerate at 2–8°C (36–46°F). Do not freeze. Protect from light. Keep in its original packaging until ready to use. Do not use if the liquid is discolored, cloudy, or contains particles.

## Clinical evidence and effectiveness

In the UltIMMa-1 and UltIMMa-2 trials for plaque psoriasis, approximately 75% of Skyrizi patients achieved PASI 90 (90% skin clearance) at week 16. For Crohn's disease, the ADVANCE, MOTIVATE, and FORTIFY trials showed robust induction and maintenance remission rates. Clinical guidelines now include Skyrizi as a preferred biologic for both psoriasis and Crohn's disease.

## Key takeaways

• Skyrizi is an IL-23 inhibitor approved for plaque psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis.
• It requires TB screening and infection evaluation before starting.
• Live vaccines must be avoided during treatment.
• Manufacturer savings programs can significantly reduce out-of-pocket costs.
• Attend all follow-up appointments so response can be assessed and continued treatment justified.

## Medical disclaimer

This article about Skyrizi (risankizumab) is for general education and is not a substitute for professional medical advice, diagnosis, or treatment. Always follow the guidance of your physician or pharmacist and the instructions on your prescription label.