Key takeaways:
Skyrizi (risankizumab-rzaa) is an injectable medication that treats psoriasis and psoriatic arthritis in adults and children ages 6 and older. It also treats ulcerative colitis and Crohn’s disease in adults.
Skyrizi works by blocking a protein called interleukin-23. This reduces inflammation in the skin, joints, and gastrointestinal tract to help improve your symptoms.
For psoriasis or psoriatic arthritis, you can inject Skyrizi at home once you’ve been trained to do so. For Crohn’s disease or ulcerative colitis, the first 3 doses of Skyrizi are given as intravenous infusions. After that, you can inject the medication at home.
There are many ways to save on Skyrizi. If you’re eligible, a manufacturer copay savings card can help you access Skyrizi for as little as $0 per month. A patient assistance program is also available.
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Biologic medications are powerful tools for tackling autoimmune conditions. These medications target specific processes in the body to reduce inflammation and improve symptoms. Skyrizi (risankizumab-rzaa) is one example.
Below, we’ll dive into what Skyrizi is used for, how it works, and common side effects to consider when deciding whether it’s the right treatment for you.
What is Skyrizi used for?
Skyrizi is an injectable medication that’s FDA approved for moderate-to-severe psoriasis and active psoriatic arthritis in adults and children ages 6 and older. It’s also approved to treat moderate-to-severe Crohn’s disease and ulcerative colitis in adults.
But Skyrizi wasn’t approved for all of these conditions at once; it took several years. Here’s a timeline of Skyrizi’s FDA approvals:
Originally approved for psoriasis in April 2019 (for adults only)
Approved for psoriatic arthritis in January 2022 (for adults only)
Approved for Crohn’s disease in June 2022 (for adults only)
Approved for ulcerative colitis in June 2024 (for adults only)
Approved for psoriasis and psoriatic arthritis in children ages 6 and older in June 2026
How does Skyrizi work?
Skyrizi is a monoclonal antibody — a lab-made antibody (protein). It works by blocking a protein in your body called interleukin-23 (IL-23).
IL-23 plays an important role in your immune system. But people living with an autoimmune condition, such as psoriasis or Crohn’s disease, can have higher levels of IL-23 than usual. This leads to excess inflammation.
By blocking IL-23, Skyrizi decreases inflammation in the skin, joints, and gut, which can help improve symptoms. In some cases, it can also slow down disease progression.
How often do you receive Skyrizi?
Your Skyrizi dosage and dosage form will depend on what health condition you’re treating.
For psoriasis or psoriatic arthritis, adults typically start with two 150 mg doses injected under the skin 4 weeks (1 month) apart. After that, the dosage is 150 mg injected every 12 weeks (3 months).
For children ages 6 and older, the Skyrizi dosage for psoriasis or psoriatic arthritis starts with two 55 mg doses injected 4 weeks apart. After that, the dosage is 55 mg injected every 12 weeks. Children who weigh 40 kg (88 lbs) or more follow the adult dosage schedule.
Your prescriber should show you how to inject Skyrizi at your first appointment. Then, you can inject Skyrizi on your own at home into your stomach or the top of your thigh. If someone else is giving you an injection, or you’re giving an injection to your child, the outside of the upper arm is also an option.
For inflammatory bowel conditions, you’ll receive your first doses of Skyrizi as intravenous (IV) infusions. For Crohn’s disease, you’ll typically start with 3 infusions of 600 mg given over 1 hour every 4 weeks. For ulcerative colitis, you’ll typically start with 3 infusions of 1,200 mg given over 2 hours every 4 weeks. For either condition, after your first 3 doses, you’ll inject 180 mg to 360 mg under the skin at home once every 8 weeks (2 months).
What are the potential side effects of Skyrizi?
Like all medications, Skyrizi has side effects to be aware of. Common Skyrizi side effects include:
Upper respiratory tract infections, such as the common cold
Feeling tired
Pain and swelling where Skyrizi was injected
Tinea (fungal) infections, such as athlete’s foot and ringworm
While rare, serious side effects, such as liver problems and skin rashes, are also possible.
Because it slows your immune system activity, Skyrizi raises your risk of severe infections, such as:
Cellulitis (skin infection)
Osteomyelitis (bone infection)
Sepsis (blood infection complication)
While you’re receiving Skyrizi, your healthcare team should monitor you for signs and symptoms of infection. As a precaution, you’ll also be screened for existing infections, such as tuberculosis, hepatitis B and C, and HIV, before starting Skyrizi. It’s also important to ensure you’re up to date on your regular vaccinations to decrease your infection risk.
How well does Skyrizi work?
Skyrizi is considered a safe and effective treatment option for the autoimmune conditions it treats. Below, we detail what researchers found in clinical studies on Skyrizi by condition.
Skyrizi for psoriasis
What we know about Skyrizi's effectiveness for psoriasis in adults comes from the UltlMMa-1 and UltlMMa-2 studies.
In both studies, Skyrizi was compared to Stelara (ustekinumab) and a placebo (an injection with no medication in it) for people living with moderate-to-severe psoriasis.
In both studies, after 16 weeks (4 months), about 75% of people receiving Skyrizi achieved 90% clearer skin. For the majority of this group, Skyrizi’s benefits continued through the first year of treatment. And in both studies, people receiving Skyrizi had significantly better results than those who received Stelara or a placebo.
Skyrizi’s effectiveness for psoriasis in children comes from the OptIMMize-1 and OptIMMize-2 studies. Similar to the adult studies, Skyrizi was compared to Stelara and a placebo, and provided better results — including complete skin clearance in over 40% of adolescents treated.
Skyrizi for psoriatic arthritis
Most of what we know about Skyrizi’s effectiveness for psoriatic arthritis in adults comes from the KEEPsAKE-1 and KEEPsAKE-2 studies. These studies looked at adults living with active psoriatic arthritis who were new to biologics or hadn’t responded well to other biologic treatments. In these studies, Skyrizi was compared to a placebo over 24 weeks (6 months).
By the end of these studies, nearly 60% of participants receiving Skyrizi had at least 20% improvement in joint pain, stiffness, and swelling. Study participants maintained these benefits for up to 100 weeks.
Skyrizi wasn’t directly studied for psoriatic arthritis in children. Instead, this approval was based on the psoriasis studies in children mentioned previously, as well as the information from the psoriatic arthritis studies in adults.
Skyrizi for Crohn’s disease
Skyrizi was tested as a treatment for Crohn’s disease in the ADVANCE and MOTIVATE studies. These trials involved people living with moderate-to-severe Crohn’s disease. Skyrizi was compared to a placebo over 12 weeks.
By week 12, people receiving Skyrizi were twice as likely to achieve clinical remission and intestinal healing compared to those taking a placebo. People who responded to Skyrizi maintained improvement after 1 year.
Skyrizi for ulcerative colitis
Skyrizi’s approval for ulcerative colitis is based on the INSPIRE and COMMAND studies. Both studies included people living with moderate-to-severe ulcerative colitis. In the INSPIRE study, the participants had not responded well to earlier biologic treatments. In the COMMAND study, most people were new to biologic therapy. Skyrizi was compared to a placebo in both studies.
After 12 weeks, more people receiving Skyrizi reached clinical remission compared to those taking a placebo. Many also showed healing in the gut, based on endoscopic exams. People who responded to Skyrizi and continued using it were able to maintain these results for 1 year.
These findings suggest that Skyrizi may help reduce symptoms and inflammation for people with ulcerative colitis, even if past treatments weren’t effective.
How to save on Skyrizi
There are ways to save on Skyrizi, which is only available as a reference (brand-name) medication. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription:
Save with a patient assistance program. If you’re uninsured or underinsured, you may be eligible for Skyrizi’s patient assistance program, which offers the medication free of cost.
Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 per dose of Skyrizi using a savings card from the manufacturer.
Frequently asked questions
You should avoid receiving live vaccines while receiving Skyrizi. There’s a higher risk of live vaccines causing an infection, since Skyrizi weakens your immune system. It’s also a good idea to limit alcohol, since it can worsen inflammation and raise your risk of infections. Talk with your healthcare team before taking any over-the-counter supplements, since some may interfere with Skyrizi’s effects. Examples include echinacea, ginseng, and melatonin.
There are a few reasons Skyrizi may cause itching for some people. Itching is a common symptom of an injection site reaction. This is usually temporary, going away within a day or two after the injection. In rare cases, Skyrizi may cause a skin rash that’s itchy. Itchiness is also a possible symptom of an allergic reaction, an infection, or liver problems. These aren’t common Skyrizi side effects. But it’s always best to let your prescriber know about any itchiness you experience, so they can determine the cause and best treatment options.
Skyrizi is typically a long-term treatment. In most cases, you’ll continue injecting Skyrizi unless it stops working or you experience bothersome side effects. If you stop Skyrizi treatment, the symptoms of your autoimmune condition will likely return. So it’s best to talk to your prescriber about your options if you’re considering stopping treatment.
You should avoid receiving live vaccines while receiving Skyrizi. There’s a higher risk of live vaccines causing an infection, since Skyrizi weakens your immune system. It’s also a good idea to limit alcohol, since it can worsen inflammation and raise your risk of infections. Talk with your healthcare team before taking any over-the-counter supplements, since some may interfere with Skyrizi’s effects. Examples include echinacea, ginseng, and melatonin.
There are a few reasons Skyrizi may cause itching for some people. Itching is a common symptom of an injection site reaction. This is usually temporary, going away within a day or two after the injection. In rare cases, Skyrizi may cause a skin rash that’s itchy. Itchiness is also a possible symptom of an allergic reaction, an infection, or liver problems. These aren’t common Skyrizi side effects. But it’s always best to let your prescriber know about any itchiness you experience, so they can determine the cause and best treatment options.
Skyrizi is typically a long-term treatment. In most cases, you’ll continue injecting Skyrizi unless it stops working or you experience bothersome side effects. If you stop Skyrizi treatment, the symptoms of your autoimmune condition will likely return. So it’s best to talk to your prescriber about your options if you’re considering stopping treatment.
The bottom line
Skyrizi (risankizumab-rzaa) was first FDA approved for moderate-to-severe psoriasis in adults. Since then, it’s also been approved for psoriatic arthritis, Crohn’s disease, and ulcerative colitis in adults. It’s also approved for psoriasis and psoriatic arthritis in children ages 6 and older.
Skyrizi works by blocking interleukin-23, an immune system protein that can lead to inflammation. This helps reduce symptoms of the autoimmune conditions it treats. If you’re using Skyrizi to treat psoriasis or psoriatic arthritis, you can inject it under the skin at home after you learn how. For Crohn’s disease or ulcerative colitis, treatment begins with 3 intravenous infusions of Skyrizi. But after that, you can inject your doses at home.
Skyrizi is considered a safe and effective treatment option. Talk to your healthcare professional to determine if Skyrizi is the right option for your needs.
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