Biologic DMARD — IL-23 Inhibitor (Anti-p19) Pregnancy: As a precautionary measure it is preferable to avoid use during pregnancy. There are no or limited data (fewer than 300 pregnancy outcomes) from use in pregnant women; animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity. Women of childbearing potential should use an effective method of contraception during treatment and for at least 21 weeks after treatment. It is unknown whether risankizumab is excreted in human milk; a risk to the breast-fed infant cannot be excluded during the first few days after birth.

Risankizumab (Rheumatology)

Brand names: Skyrizi

Risankizumab is a subcutaneously administered anti-interleukin-23 (p19) monoclonal antibody; within rheumatology it is used for active psoriatic arthritis, as well as plaque psoriasis and inflammatory bowel disease.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 150 mg (psoriatic arthritis)

Route: Subcutaneous injection into the thigh or abdomen (administration in the upper, outer arm may only be performed by a healthcare professional or caregiver)

Frequency: At week 0, week 4, and every 12 weeks thereafter

Fetched UK SPC: Skyrizi 150 mg solution for injection in pre-filled pen (eMC product 12625). Intended for use under the guidance and supervision of a physician experienced in the diagnosis and treatment of the conditions for which it is indicated. The 150 mg dose may be given either as two 75 mg pre-filled syringe injections or as one 150 mg pre-filled pen or pre-filled syringe injection. Adult plaque psoriasis uses the same regimen — 150 mg at week 0, week 4 and every 12 weeks thereafter. For both indications, consideration should be given to discontinuing treatment in patients who have shown no response after 16 weeks; some plaque psoriasis patients with an initial partial response may subsequently improve with continued treatment beyond 16 weeks. Missed dose: administer as soon as possible, then resume the regular schedule. No dose adjustment is required in the elderly (65 years and over) or in overweight patients. Patients may self-inject after training in subcutaneous injection technique. Do not inject into skin that is tender, bruised, erythematous, indurated or affected by psoriasis. Paediatric (the SPC gives fixed weight-band doses, not a per-kg dose, so paedDose is null): for PAEDIATRIC PLAQUE PSORIASIS from 6 to less than 18 years of age the dose is based on body weight and given subcutaneously at week 0, week 4 and every 12 weeks thereafter — less than 40 kg, 55 mg (given as one 55 mg pre-filled syringe injection, for which the separate Skyrizi 55 mg pre-filled syringe SmPC should be consulted); 40 kg or more, 150 mg. In children and adolescents 10 to less than 18 years of age it is recommended that Skyrizi is administered by or under the supervision of an adult; in children 6 to less than 10 years of age it should be administered by an adult. Safety and efficacy in children and adolescents below 18 years with PSORIATIC ARTHRITIS have not been established and no data are available; there is no relevant use below 6 years for plaque psoriasis or below 5 years for psoriatic arthritis. Verify any under-18 use against a children's formulary. Neither the fetched eMC bundle (§4.5 not retrieved) nor the fetched US label (Skyrizi, AbbVie, label date 2026-06-15) contains a drug interactions section, so no interactions are listed below.

Dose adjustments

Renal

No specific studies were conducted to assess the effect of renal (or hepatic) impairment on the pharmacokinetics of risankizumab; these conditions are generally not expected to have any significant impact on the pharmacokinetics of monoclonal antibodies and no dose adjustments are considered necessary.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients
Clinically important active infections (e.g. active tuberculosis)

Side effects

Upper respiratory infections (very common — 13.0% in psoriasis; includes respiratory tract infection, sinusitis, rhinitis, nasopharyngitis, pharyngitis, tonsillitis, laryngitis, tracheitis)
Tinea infections (common); folliculitis (uncommon)
Headache (common)
Pruritus, rash and eczema (common); urticaria (uncommon)
Fatigue and injection site reactions (common)
Anaphylactic reactions (rare)

Clinical monograph

How it works

It selectively binds the p19 subunit of interleukin-23, inhibiting IL-23 signalling and the downstream Th17 inflammatory pathway that drives psoriatic skin and joint disease.

Prescribing in practice

Exclude active infection, including active tuberculosis, before starting and screen for latent TB, treating it before therapy as a key safety step.
Avoid live vaccines during treatment and update immunisations beforehand where possible.
Hypersensitivity reactions can occur, and patients should be monitored for new or worsening infection during treatment.

Monitoring

Monitor clinically for infection and for treatment response, with tuberculosis status reviewed before and as indicated during therapy.

Counselling the patient

Report signs of infection that are severe or persistent.
It is given as a subcutaneous injection and self-injection can be taught.
Tell us about planned vaccinations so timing can be advised.

Evidence & guidelines

Use in psoriatic arthritis is supported by randomised controlled trials showing significant improvement in joint and skin outcomes.

Reference: NICE TA775; KEEPsAKE 1 Trial (Lancet 2021); KEEPsAKE 2 Trial (Ann Rheum Dis 2021); SPC Skyrizi; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Guselkumab · Biologic DMARD — IL-23 Inhibitor (Anti-p19)

Pathways