Risankizumab redefines Crohn’s treatment after ustekinumab failure

Table 2 Comparative context for biologic switch strategies after ustekinumab failure in Crohn’s disease

Parameter	Risankizumab	Vedolizumab	Anti-TNF
Ref.	Colwill et al[6], 2025	Bressler et al[14], 2021	Allez et al[15], 2010
Study design	Single-center retrospective	Multicenter retrospective	Various retrospective
Sample size (n)	51	78	Approximately 50-100 per cohort
Follow-up	9 months	12 months	6-12 months
Clinical remission rate	94.4% (34/36)	39% (at 12 months)	Approximately 20%-40% (variable)
Biomarker improvement (CRP/FCal)	Significant (P < 0.001)	Modest	Modest to significant
Key strengths	High remission rates; excellent safety profile in this cohort	Distinct gut-selective mechanism; well-established safety	Extensive clinical experience; potential for dose optimization
Key limitations	Single-center; no endoscopic data; potential for selection bias	Lower remission rates in this setting	Immunogenicity; potential for attenuated response in later lines of therapy

TNF: Tumor necrosis factor; CRP: C-reactive protein; FCal: Fecal calprotectin.