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Dual-targeted therapy with risankizumab and upadacitinib in medically complex Crohn's disease
Evan N Fear1, Benjamin D McDonald1, Megan S Kennedy1
1University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, United States.
Crohn'S & Colitis 360
|June 22, 2026
Summary
Dual-targeted therapy (DTT) with risankizumab (RISA) and upadacitinib (UPA) shows promise for Crohn
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Crohn's disease (CD) presents significant unmet therapeutic needs.
- Previous research explored ustekinumab plus upadacitinib (UPA) as a dual-targeted therapy (DTT).
- This study investigates risankizumab (RISA), an IL-23 inhibitor, combined with UPA for CD treatment.
Purpose of the Study:
- To evaluate the safety and effectiveness of risankizumab (RISA) and upadacitinib (UPA) combination therapy in Crohn's disease patients.
- To assess clinical response, remission rates, and extraintestinal manifestation outcomes.
- To analyze adverse events associated with this DTT regimen.
Main Methods:
- Retrospective analysis of a prospectively collected real-world database.
- Inclusion of Crohn's disease patients treated with RISA and UPA between November 2021 and September 2024.
- Evaluation of clinical outcomes, extraintestinal manifestations, and adverse events, including patients with ileostomies.
Main Results:
- Nineteen patients with CD received RISA and UPA; most had extensive prior treatment and prior surgeries.
- Among patients with active disease, 71.4% achieved clinical remission and 28.6% achieved clinical response without remission.
- Significant improvements were observed in extraintestinal manifestations, with 87.5% of affected patients showing improvement.
Conclusions:
- Dual-targeted therapy with risankizumab and upadacitinib is effective in medically resistant Crohn's disease.
- The combination therapy demonstrates a favorable safety profile.
- This DTT approach offers a potential new option for managing refractory CD.
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