What is the recommended frequency for tuberculosis (TB) testing in patients taking Skyrizi (risankizumab)?

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Last updated: May 20, 2025View editorial policy

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From the Research

If you're on Skyrizi (risankizumab), you should get tested for tuberculosis (TB) before starting treatment and then typically once per year during therapy, as this regular testing is necessary because Skyrizi suppresses parts of your immune system, potentially reactivating latent TB infection that your body previously contained 1.

Key Considerations

  • The initial TB screening should include either a tuberculin skin test (TST) or an interferon-gamma release assay (IGRA) blood test, along with a chest X-ray if indicated.
  • The medication works by blocking interleukin-23, which helps control inflammation but also plays a role in fighting certain infections like TB.
  • If you develop any TB symptoms during treatment (persistent cough, fever, night sweats, weight loss), contact your healthcare provider immediately for additional testing, regardless of your regular screening schedule.

Risk Factors

  • Your doctor may adjust this testing frequency based on your individual risk factors, such as:
    • Previous TB exposure
    • Travel to TB-endemic areas
    • Work in healthcare settings

Testing Methods

  • Both TST and IGRA are acceptable but imperfect tests for detecting LTBI, with moderate agreement between them 2.
  • IGRAs may add diagnostic power in certain scenarios, particularly in patients with negative TST at baseline 3.

Recent Guidelines

  • Recent studies emphasize the importance of LTBI screening and treatment in high-risk populations, including those with compromised immune systems 4.
  • The use of interferon-gamma release assay and isoniazid/rifapentine has been shown to be effective in eradicating latent tuberculosis in people living with HIV/AIDS 4.

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.

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