Risankizumab, Upadacitinib Show Durable Real-World IBD Outcomes at DDW 2026

AbbVie presented 18 abstracts on risankizumab (SKYRIZI) and upadacitinib (RINVOQ) at the 2026 Digestive Disease Week (DDW) Annual Meeting in Chicago, May 2–5, offering clinicians new long-term and real-world evidence regarding efficacy durability, treatment persistence, and clinical outcomes in patients with Crohn's disease (CD) and ulcerative colitis (UC). The data, drawn from both prospective observational studies and retrospective US claims analyses, add to an expanding evidence base for two agents that have reshaped advanced IBD therapy since their respective regulatory approvals.

"Our research presented at DDW adds to the growing body of evidence demonstrating the sustained durability of clinical and endoscopic response, as well as the established safety profile, of risankizumab and upadacitinib for people living with IBD," said Andrew Anisfeld, PhD, vice president of global medical affairs, immunology, at AbbVie.

Risankizumab Real-World Data in Crohn's Disease

The ASPIRE-CD study, a prospective real-world registry, provided 52-week follow-up data in adults with moderately to severely active CD initiating risankizumab. According to the study findings presented at DDW, patients experienced rapid and sustained reductions in abdominal pain, bowel urgency, and liquid or soft stools over the observation period. Corticosteroid use declined markedly, falling from 34% at baseline to 7% at Week 52, while over-the-counter therapy use dropped from 72% to 49%. Among patients with extraintestinal manifestations, 25% of those with arthritis and 46% of those with skin conditions reported symptom relief by Week 52.

A separate analysis from ASPIRE-CD focused on health-related quality of life (HRQL) and treatment satisfaction. The researchers reported that 77% of patients noted improvement in life enjoyment by Week 52, with additional gains in general wellbeing, sexual health, and work productivity. Overall treatment satisfaction rose from 50% at baseline to approximately 87% at Week 52 across all patients, and to 92% among those who remained on risankizumab at that time point.

Treatment Persistence and Real-World Switching Rates

A retrospective analysis of US claims data examined biologic switch rates over 24 months in patients with CD initiating a new biologic. The 14% switch rate observed for risankizumab was lower than rates reported for ustekinumab (21%), vedolizumab (30%), infliximab (33%), and adalimumab (36%), according to the study findings. The investigators reported that this pattern held in biologic-naïve patients as well. While lower switch rates may reflect treatment durability, real-world claims analyses are subject to confounding by indication, and direct causal inference is limited without randomized comparative data.

Upadacitinib: Hospitalization Outcomes and Perianal Fistulizing Disease

A propensity score–matched retrospective analysis of US claims data compared patients with CD or UC who switched to upadacitinib against those who underwent dose escalation of a current biologic. Patients who switched to upadacitinib demonstrated 31% lower odds of hospitalization and 26% lower odds of emergency department visits than those who escalated biologic dosing, according to the study. These findings, while hypothesis-generating, require prospective validation.

In a post-hoc analysis of two Phase 3 trials in perianal fistulizing CD (PFCD), patients who responded to upadacitinib 45 mg induction were re-randomized to maintenance with upadacitinib 15 mg, 30 mg, or placebo for 52 weeks. Upadacitinib-treated patients demonstrated endoscopic improvements through Week 52 as measured by the Simple Endoscopic Score for Crohn's Disease (SES-CD), regardless of fistula response status. The majority of patients in this cohort had inadequate prior response to anti-TNF therapy.

Clinical Context and Drug Background

Risankizumab is a selective IL-23 inhibitor targeting the p19 subunit, FDA-approved for moderately to severely active CD, UC, plaque psoriasis, and psoriatic arthritis.¹ AbbVie announced on April 27, 2026, that it had submitted an application to the FDA for approval of a subcutaneous induction formulation for CD. Upadacitinib is a JAK inhibitor with preferential JAK-1 selectivity, approved for multiple immune-mediated inflammatory conditions including CD and UC, among others.² Both agents carry established safety considerations: risankizumab requires monitoring for serious infections, TB reactivation, and hepatotoxicity in IBD settings; upadacitinib carries boxed warnings regarding serious infections, malignancy, major adverse cardiovascular events, and thrombosis.

Limitations and Next Steps

The ASPIRE-CD data derive from an industry-sponsored observational study without a concurrent control arm, limiting causal interpretation. The claims-based analyses are subject to residual confounding, selection bias, and coding variability. Post-hoc analyses of the PFCD Phase 3 trials, while exploratory and informative, were not pre-specified primary endpoints. Peer-reviewed publications from the DDW abstracts had not been released at the time of reporting. Prospective, head-to-head comparative trials would strengthen the clinical inferences suggested by these datasets.

References

1. SKYRIZI [Package Insert]. North Chicago, IL: AbbVie Inc.; 2026.
2. RINVOQ [Package Insert]. North Chicago, IL: AbbVie Inc.; 2025.
3. AbbVie. AbbVie highlights new long-term data advancing treatment standards in inflammatory bowel diseases (IBD) at 2026 Digestive Disease Week. PR Newswire. May 5, 2026. https://www.prnewswire.com/news-releases/abbvie-highlights-new-long-term-data-advancing-treatment-standards-in-inflammatory-bowel-diseases-ibd-at-2026-digestive-disease-week-302761754.html