Real-World Experience of Risankizumab in Refractory Pediatric Inflammatory Bowel Disease

The incidence of pediatric inflammatory bowel disease (IBD) is rising globally. Anti-tumor necrosis factor agents remain the mainstay of treatment, but a significant number of patients experience treatment failure. This case-series presents real-world experience using risankizumab, an IL-23 inhibitor, in 9 children with severe-refractory IBD. Multiple biologics had failed in all patients before initiation. Response was assessed using symptoms, biomarkers, endoscopy, and imaging. Five patients achieved clinical remission, and 4 failed to achieve complete remission. Noninvasive monitoring tools, such as intestinal ultrasound, were used. No adverse events were reported. Risankizumab may be a promising option in refractory pediatric IBD.