Early Endoscopic Outcomes After Risankizumab Are Associated With Fewer Hospitalizations and Surgeries in Crohn's...

Area of Science:

• Gastroenterology
• Immunology
• Clinical Therapeutics

Background:

• Crohn's disease (CD) management requires evaluating treatment efficacy beyond clinical symptoms.
• Endoscopic healing is a critical target in CD treatment, potentially impacting long-term disease course.
• Risankizumab is an interleukin-23 inhibitor used for moderate to severe CD.

Purpose of the Study:

• To assess the association between endoscopic outcomes after risankizumab induction and subsequent rates of hospitalization and surgery.
• To evaluate the impact of achieving endoscopic response, remission, or ulcer-free status on CD-related healthcare utilization during maintenance therapy.

Main Methods:

• Patients with moderately to severely active CD who responded to 12-week risankizumab induction were rerandomized in the FORTIFY trial.
• Rates of CD-related hospitalization and surgery were compared between patients achieving specific endoscopic outcomes versus those who did not.
• Data were analyzed through 52 weeks of risankizumab maintenance therapy.

Main Results:

• Patients achieving endoscopic response, remission, or ulcer-free endoscopy after risankizumab induction had significantly lower rates of CD-related hospitalization (P < .05).
• No CD-related surgeries were observed in patients achieving endoscopic outcomes during maintenance, compared to those who did not (P = .025).
• In contrast, placebo recipients showed similar hospitalization and surgery rates regardless of prior endoscopic achievement.

Conclusions:

• Achieving endoscopic outcomes with risankizumab induction is associated with reduced hospitalizations and surgeries during maintenance therapy.
• Early treatment success, indicated by endoscopic healing, may predict favorable long-term outcomes in Crohn's disease patients.
• Continued risankizumab therapy following endoscopic improvement is linked to sustained clinical benefits.