Skyrizi (Risankizumab) - New biologic treatment approved for psoriatic arthritis in Scotland

The injectable treatment gets approval from the Scottish Medicines Consortium.

The Scottish Medicines Consortium (SMC) has published its decision to recommend the biologic medicine, Skyrizi (also known by its generic name, Risankizumab), for the treatment of adults with psoriatic arthritis in Scotland.

The SMC guidance states that Skyrizi, either alone or in combination with methotrexate, is recommended as an option for treating active psoriatic arthritis in adults in the following circumstances:

• When the individual's psoriatic arthritis has not responded adequately to two previous conventional disease-modifying antirheumatic drugs (DMARDs) or they cannot tolerate these treatments, and they have not yet received a biologic medication (biologic-naïve population);
• When the individual's psoriatic arthritis has not responded adequately to conventional DMARDs and one or more biologic medications from the tumour necrosis factor (TNF) inhibitor class, such as Adalimumab, Cimzia, Etanercept, Infliximab or Simponi, (biologic-experienced population);
• When the individual cannot take or tolerate biologic medications from the tumour necrosis factor (TNF) inhibitor class.


How does Skyrizi work?

Skyrizi blocks the activity of interleukin-23 (IL-23), a chemical ‘messenger’ in the immune system which signals other cells to cause inflammation. In people with psoriasis and/or psoriatic arthritis, the immune system is overactive and creates too much inflammation, which leads to the development of psoriasis and/or psoriatic arthritis symptoms. Skyrizi is very precise and binds to a specific part of the IL-23 messenger, called p19. This then blocks IL-23 from sending out the inflammation signals and processes, preventing some of the inflammation from occurring and leading to an improvement in psoriasis and psoriatic arthritis for some people who take it.

How is Skyrizi used?

Skyrizi is taken as an injection under the skin via a pre-filled syringe or pre-filled injection pen. The recommended dose is 150mg. When Skyrizi was launched you needed to have two injections of 75mg at each dose. However, as of 9th July 2021 each injection now contains the full dose (150mg) and so only one injection is required each time. The injections should be administered in areas such as the thighs or abdomen avoiding where the skin is tender, bruised or affected by psoriasis.

When you begin taking Skyrizi you will have your first injection(s), followed four weeks later by your next. After that Skyrizi is usually taken every 12 weeks. Most people will be trained by a nurse to give the injection to themselves.

People taking Skyrizi are likely to need regular blood tests – usually carried out by a Rheumatology specialist, or by their own GP, to monitor general health whilst on the treatment.

People taking Skyrizi are more at risk of infections and so should be vaccinated against pneumonia and have an annual flu vaccination. However, not all vaccinations are safe in people taking Skyrizi and ‘live’ vaccinations (for example yellow fever, shingles) should not be given whilst on Skyrizi and for one year after stopping Skyrizi. Check with a doctor, nurse or pharmacist before having any vaccinations or taking other medication if you are not sure.

For more information on Skyrizi, have a read of our information sheet.