What is the effect of Skyrizi (risankizumab) on alkaline phosphatase (Alk Phos) levels in bone?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 13, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Research

Skyrizi (risankizumab) may cause elevated alkaline phosphatase (ALP) levels, which could potentially impact bone health in some patients, and according to the most recent study 1, it is essential to monitor liver function tests, including ALP, during Skyrizi treatment. If you're experiencing increased ALP levels while on Skyrizi, it's crucial to consult with your healthcare provider for proper evaluation. They may recommend regular monitoring of your liver function tests, including ALP, during Skyrizi treatment. While Skyrizi primarily targets IL-23 to treat conditions like psoriasis and psoriatic arthritis, it can occasionally affect liver enzymes as a side effect, as seen in the study 2. If ALP elevation is specifically related to bone metabolism rather than liver function, your doctor might order additional tests like bone-specific ALP or vitamin D levels to determine the cause, as discussed in the study 3. Treatment approaches may include:

  • Calcium and vitamin D supplementation (typically 1000-2000 IU daily)
  • Weight-bearing exercise
  • Possibly adjusting your Skyrizi dosing schedule (standard dosing is 150 mg at weeks 0,4, and every 12 weeks thereafter), as mentioned in the study 4. The connection between Skyrizi and bone-specific ALP changes is not well-established, so individualized monitoring and management by your healthcare provider is essential to ensure both effective treatment of your underlying condition and maintenance of bone health, as highlighted in the study 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.