Med Review: SEQUENCE Trial: Risankizumab vs Ustekinumab in Anti-TNF-Refractory Crohn’s Disease

Thank you to AbbVie for their support on this Medication Review Video Module.

In this medication review, Sharon Dudley-Brown, CRNP, PhD from Johns Hopkins University and Angelina Collins, MSN, ANP-BC, from the University of California San Diego, provide a comprehensive overview of the SEQUENCE trial, a landmark head-to-head study comparing risankizumab and ustekinumab in patients with moderate to severe Crohn’s disease who had previously failed anti-TNF therapy. The discussion explores the trial design, patient population, dosing strategies, primary and secondary endpoints, and the significance of efficacy assessor blinding in an open-label study.

Sharon and Angelina review key findings demonstrating the superiority of risankizumab over ustekinumab across multiple clinical and endoscopic outcomes, including clinical remission, endoscopic response, corticosteroid-free remission, and long-term disease control. They also discuss the importance of objective disease assessment using centrally read endoscopy and the role of steroid tapering in evaluating treatment success. Safety outcomes are examined, highlighting the absence of new safety signals and reinforcing the established safety profile of risankizumab.

This educational video is designed for gastroenterology nurse practitioners, physician assistants, and other healthcare professionals seeking practical insights into evidence-based treatment selection for Crohn’s disease. Viewers will gain a deeper understanding of how the SEQUENCE study may influence treatment positioning of IL-23 therapies in anti-TNF-experienced patients and how emerging long-term extension data continue to support durable clinical remission and endoscopic improvement with risankizumab.