From the Research
Risankizumab should be used with caution in patients with a history of acute pancreatitis, though there is no absolute contraindication. Before initiating treatment, a thorough assessment of the patient's pancreatitis history, including cause, severity, and time since last episode, should be conducted 1. Baseline pancreatic enzyme levels (amylase and lipase) should be measured prior to starting therapy. During treatment, patients should be monitored for signs and symptoms of pancreatitis such as severe abdominal pain, nausea, vomiting, and elevated pancreatic enzymes. If pancreatitis is suspected, risankizumab should be temporarily discontinued and appropriate diagnostic workup performed. The standard dosing of risankizumab for plaque psoriasis is 150 mg administered by subcutaneous injection at weeks 0,4, and every 12 weeks thereafter, though this may need adjustment based on individual patient factors.
Key Considerations
- Patients with a history of acute pancreatitis are at increased risk of recurrent pancreatitis, with risk factors including smoking history, infected pancreatic necrosis, and high low-density lipoprotein cholesterol (LDLc) level 1.
- Immunomodulatory medications like risankizumab may alter inflammatory responses, potentially affecting pancreatic function, although direct causation between risankizumab and pancreatitis has not been firmly established.
- Patients should be educated about potential warning signs of pancreatitis and advised to seek immediate medical attention if these develop.
Monitoring and Management
- Regular monitoring of pancreatic enzyme levels and clinical symptoms is crucial during risankizumab treatment.
- If pancreatitis is suspected, prompt diagnostic workup and temporary discontinuation of risankizumab are necessary.
- Individualized treatment plans may be required based on patient-specific factors, such as severity of pancreatitis history and presence of risk factors.