Gastroenterology Review
eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
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abstract:
Original paper

RESCUE-CD – Real-world effectiveness of risankizumab in moderate-to-severe Crohn’s disease: a case series involving the most refractory and challenging patients

Konrad Lewandowski
1
,
Katarzyna Karłowicz
1
,
Joanna Sarbinowska
2
,
Maciej Gonciarz
2
,
Dagmara Mahadea
3
,
Liliana Łykowska-Szuber
3
,
Piotr Eder
3
,
Anna Chaber-Ciopińska
4, 5
,
Edyta Zagórowicz
4, 5
,
Grażyna Rydzewska
1, 6

  1. Department of Gastroenterology and Internal Medicine, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
  2. Department of Gastroenterology and Internal Medicine, Military Institute of Medicine – National Research Institute, Warsaw, Poland
  3. Department of Gastroenterology, Dietetics, and Internal Diseases, Poznan University of Medical Sciences, H. Święcicki University Hospital, Poznan, Poland
  4. Department of Oncological Gastroenterology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
  5. Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
  6. Collegium Medicum, Jan Kochanowski University, Kielce, Poland
Gastroenterology Rev
DOI: https://doi.org/10.5114/pg.2026.159896
Online publish date: 2026/03/10
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Introduction
Selective interleukin-23 (IL-23) blockade with risankizumab (RZB) is effective in moderate-to-severe Crohn’s disease (CD), but evidence in highly refractory populations remains limited.

Aim
We assessed real-world effectiveness and safety of RZB in a retrospective multicenter case series of adult patients with CD previously exposed to multiple biologics and small molecules, including selected cases of dual-targeted therapy.

Material and methods
Patients from four Polish tertiary IBD centers who initiated standard-dose RZB before 1 December 2025 were included. Disease activity was evaluated using the Crohn’s Disease Activity Index (CDAI). Primary endpoints were clinical response and remission at week 12 and last follow-up. Secondary endpoints included corticosteroid (CS)-free remission, CS dose reduction, improvement in extraintestinal manifestations and perianal disease, and safety.

Results
Fourteen highly refractory patients were analyzed (mean age: 35.2 years; mean disease duration: 13.9 years). Baseline disease activity was severe (mean: CDAI 376); 71.4% had perianal disease and 78.6% had prior CD-related surgery. CDAI declined rapidly, with a mean reduction of 279 points at last observation. At week 12, clinical response and remission were achieved in 85.7% and 57.1% of patients, respectively, increasing to 78.6% remission at follow-up. CS-free remission increased from 50.0% to 71.4%; all CS-treated patients reduced steroid dose, and 87.5% reported improvement in perianal fistulas. One mild adverse event was observed, with no serious adverse events.

Conclusions
RZB showed high and durable effectiveness with a favorable safety profile in an exceptionally refractory real-world CD population, supporting IL-23 p19 inhibition as a valuable late-line therapeutic option.

keywords:

risankizumab, real-world evidence, ulcerative colitis



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