RISANCROHN: Risankizumab Works in Highly Refractory Crohn’s—but Earlier Positioning May Matter: AP & T | September 2026 | Multicentre Real-World Study

Introduction:

Risankizumab, an IL-23p19 inhibitor, is an effective therapy for Crohn’s disease, but real-world outcomes in heavily pretreated patients are important for treatment positioning. RISANCROHN evaluated its effectiveness and safety in a large, predominantly refractory Crohn’s cohort.

Why was this study needed?

Many Crohn’s patients cycle through multiple advanced therapies.

Effectiveness often declines after repeated biologic failures.

Real-world data can clarify outcomes beyond clinical-trial populations.

Key Findings:

857 patients were included, most previously exposed to multiple biologics.

Steroid-free clinical remission reached 56% at weeks 8–12.

At last follow-up (mean 7.4 months), remission increased to 61%.

Patients exposed to ≤2 previous biologics achieved substantially better outcomes than those who had failed >2.

Risankizumab therefore remained effective even in highly refractory Crohn’s disease.

Treatment-related adverse events occurred in 8%, with no serious treatment-related events reported.

Better outcomes with fewer prior biologics suggest potential benefit from earlier positioning, but this remains hypothesis-generating.

The study was observational and cannot establish the optimal treatment sequence.

Bottom Line:

Risankizumab remains effective in heavily pretreated Crohn’s disease, but outcomes appear better with fewer prior biologic failures. These data support considering IL-23 therapy earlier, while definitive sequencing requires comparative trials.