Effectiveness of Risankizumab After Ustekinumab Failure in Crohn’s Disease: A Multicenter Retrospective Cohort Study
Dysregulation of the interleukin (IL) 23–T helper 17 cell axis has emerged as a central driver of disease pathogenesis in patients with Crohn’s disease (CD). Ustekinumab was the first approved therapy targeting this pathway in CD through IL12/23p40.1 However, mechanistic studies have demonstrated that intestinal inflammation is driven predominantly by IL23 rather than IL12.2 This distinction has translated into clinically meaningful differences in efficacy in other immune-mediated diseases such as psoriasis, where IL23p19 antagonists are superior to ustekinumab in head-to-head trials and retain efficacy even after ustekinumab failure.
