Skyrizi (risankizumab-rzaa) is a biologic medication that targets the IL-23 protein, which is linked to the inflammation that causes Crohn's disease. For adults with moderately to severely active Crohn's, the dosing schedule is carefully structured in two distinct phases: an initial induction phase to control the disease, followed by a maintenance phase to sustain remission.
The Induction Phase: Rapid Control of Inflammation
The induction phase is designed to quickly bring moderately to severely active Crohn's disease under control. This phase is administered by a healthcare professional in a medical setting and involves three intravenous (IV) infusions over eight weeks. These infusions are given at Week 0, Week 4, and Week 8, with each infusion taking at least one hour. The maintenance therapy begins four weeks after the final induction infusion.
The Maintenance Phase: Sustaining Remission
Following the induction phase, patients transition to a long-term maintenance regimen using subcutaneous injections, which can often be self-administered at home after training. The maintenance dose is determined by the doctor based on individual response. These injections are given every 8 weeks, starting at Week 12. The administration method is a subcutaneous injection, typically using a prefilled cartridge/on-body injector or a prefilled syringe. This at-home option can reduce the need for frequent clinic visits.
Comparison of Induction and Maintenance Dosing
| Feature | Induction Phase | Maintenance Phase |
|---|---|---|
| Purpose | To rapidly control active inflammation in moderate to severe Crohn's disease. | To sustain clinical remission and prevent flare-ups over the long term. |
| Dose | Specific dose administered | Specific dose administered based on response |
| Frequency | Week 0, Week 4, and Week 8 (3 doses over 8 weeks) | Every 8 weeks |
| Administration Method | Intravenous (IV) infusion, lasting at least one hour. | Subcutaneous (SC) injection via prefilled cartridge/on-body injector or syringe. |
| Administration Location | Medical facility (doctor's office, infusion center) by a healthcare professional. | At home, self-administered after receiving training. |
| Starting Point | At the beginning of treatment for active disease. | At Week 12, following the final induction dose. |
Practical Aspects of Skyrizi Treatment
Practical considerations for Skyrizi treatment include using an on-body injector, which is a hands-free device requiring training for use. For at-home injections, it's recommended to let the medication reach room temperature for a specified period beforehand. If a maintenance dose is missed, take it as soon as possible and return to the regular schedule, consulting a healthcare provider for advice. Monitoring liver function is necessary before and during treatment. Live vaccines should be avoided during treatment; it's best to complete necessary immunizations beforehand.
Conclusion
Skyrizi treatment for Crohn's disease involves an initial induction phase with three intravenous infusions and a maintenance phase with subcutaneous injections every eight weeks. The specific maintenance dose is determined by the doctor. The maintenance injections can often be done at home for convenience. Always follow your healthcare provider's specific guidance for dosing and scheduling. For more information on Crohn's disease, the {Link: Crohn's & Colitis Foundation https://www.crohnscolitisfoundation.org/patientsandcaregivers/what-is-ibd} is a helpful resource.
Effective treatment depends on adhering to the prescribed regimen and communicating openly with your healthcare team.
