Analysis of Reddit Reveals Risankizumab Questions Among Patients with Psoriasis

J Clin Aesthet Dermatol. 2025;18(6):14–17.

by Jennifer Wang, BA; Paras Patel, BA; Jessica Mineroff, MD; and Jared Jagdeo, MD, MS

Mses. Wang and Mineroff and Dr. Jagdeo are with the Department of Dermatology at the State University of New York, Downstate Health Sciences University in Brooklyn, New York. Mr. Patel is with the Rowan University School of Osteopathic Medicine in Stratford, New Jersey. Mses. Wang and Mineroff, Mr. Patel, and Dr. Jagdeo are with the Dermatology Service at the Veterans Affairs New York Harbor Healthcare System at the Brooklyn Campus in Brooklyn, New York.

FUNDING: No funding was provided for this article.

DISCLOSURES: The authors declare no conflicts of interest relevant to the content of this article.

Abstract: Objective: The rapid expansion of the internet, specifically social media, has reshaped how patients approach their health and obtain their medical information. Specifically, Reddit communities have become important spaces for patients with psoriasis to engage in discussions, particularly regarding the newly United States Food and Drug Administration-approved medication, risankizumab. The objective of this study was to analyze questions from patients with psoriasis about risankizumab on Reddit. Methods: The authors analyzed all risankizumab-related questions posted on the r/Psoriasis and r/Skyrizi subreddits. Questions were categorized and subcategorized for analysis. Results: A total of 222 questions from 181 posts were analyzed. The largest proportion of questions were regarding side effects (26.1%) and cost and insurance (14.9%). This analysis of risankizumab questions on Reddit reveals key insights into the informational needs of patients with psoriasis and demonstrates the value of utilizing online platforms to better understand patient concerns. Limitations: One limitation of this study is that Reddit users may not be representative of the overall psoriasis population. Conclusion: The study presents a distinct approach by harnessing the power of social media data to understand patient perspectives, which may not be readily apparent in clinical settings. This information may help physicians improve the overall patient experience and provide more tailored clinical care. Keywords: Psoriasis, risankizumab, skyrizi, social media

Introduction

Psoriasis is an immune-mediated dermatologic disease that affects approximately 3 percent of adults in the United States (US), or more than 7.5 million adults.¹ In addition to physical symptoms, psoriasis also has a significant negative impact on quality of life.² Psoriasis has been linked to higher rates of depression and suicide.^3,4 The introduction of biologics has transformed psoriasis treatment due to their high degree of efficacy and favorable safety profile.⁵ While there are many available types of biologics, studies have shown that newer biologics targeting the interleukin (IL)-12/23 and IL-17 pathway appear to be more effective than older biologics and oral agents.⁵ Risankizumab (Skyrizi; AbbVie Inc., North Chicago, Illinois), a monoclonal antibody directed against subunit p19 of IL-23, was approved by the US Food and Drug Administration (FDA) in 2019 for adults with moderate to severe plaque psoriasis.^6,7 Risankizumab was FDA-approved in 2021 for adults with active psoriatic arthritis.⁷ Risankizumab is one of the most effective biologics for treating psoriasis.⁸ One meta-analysis found that out of sixteen biologic medications for psoriasis, risankizumab had the highest long-term efficacy.⁸ With its popularity and high degree of efficacy, it is imperative to evaluate patients’ questions and information needs regarding risankizumab.

Almost two-thirds of adults in the US use social media, a tenfold increase over the last 10 years.⁹ Patients are increasingly using the internet and social media to obtain healthcare information and advice.¹⁰ Social media is a convenient, easily accessible, inexpensive, and often anonymous way to access healthcare information. One study found that 82.4 percent of dermatology patients use social media or the internet to obtain medical information, with 16.1 percent citing it as their most important source of medical information.¹¹ Reddit is one of the most popular social media websites, with over 52 million daily active users and 430 million monthly active users.¹² It is a user-generated online forum where users can engage in discussion about various topics on communities known as “subreddits.” The r/Psoriasis subreddit is among the top 5 percent of communities on Reddit by size. Research has shown that online communities offer patients with psoriasis a valuable source of psychological and social support.¹³ It also serves as a readily available source of information for patients to obtain their healthcare information, especially given the significant decrease in in-person dermatology visits during the COVID-19 pandemic.¹⁴

Given risankizumab’s high degree of efficacy, recent FDA approval, and growing interest online, this study seeks to utilize the social media website Reddit to uncover questions about risankizumab in patients with psoriasis. This data can help physicians gain a deeper understanding of patients’ perspectives and informational needs, potentially enhancing clinical outcomes.

Methods

The authors analyzed all posts on the r/Psoriasis and r/Skyrizi subreddits related to risankizumab, which have approximately 33,900 and 114 subscribers respectively as of July 24, 2023. Each subreddit was searched for the following terms: “risankizumab” and “Skyrizi.” The subreddit, username, title, text, comments, and number of upvotes (ie, thumbs-up or “likes”) of each post were extracted and recorded. Each risankizumab-related question was placed into one of the following categories: “side effects,” “usage instructions,”  “general experience,”  “efficacy,”  “costs and insurance,” “concurrent use with other medical interventions,”  “obtaining prescription,” “timeline for symptom improvement,”  “stopping medication,”  “dose timing,” and “miscellaneous.” Duplicate posts and posts not containing questions about risankizumab were excluded. Redundant questions within the same post were also excluded. The SUNY Downstate Institutional Review Board deemed this study exempt from review. All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was not obtained as all posts are anonymous and publicly available on the internet.

Results

Two hundred twenty-two questions from 181 posts were analyzed, as some posts contained multiple questions. In terms of the number of questions asked per year, 95 questions (42.8%) were asked in 2022 and 127 questions (57.2%) were asked in 2023 as of July 24, 2023. (Table 1). The average number of comments was 7.8 (range 0–41) and the average number of upvotes was 3.9 (range 0–37) for each post. Users posted 1.2 questions on average (range 1–7). The most popular subreddit was r/Psoriasis, which contained 90.1 percent of the questions analyzed.

The greatest proportion of questions were related to side effects (26.1%) and cost and insurance (14.9%) (Table 2). Regarding side effects, patients most frequently asked about what side effects other users experienced (41.5%). Regarding specific side effects, patients often inquired about flares (12.2%), fatigue (9.8%), and injection site reactions (9.8%). Patients also asked questions about risankizumab efficacy (11.3%), the general experience (7.2%), usage instructions (6.3%), the timeline for symptom improvement (5.9%), comparison with other medical interventions (5.0%), stopping the medication (3.6%), dose timing (3.6%), concurrent use with other medical interventions (2.7%), and the process for obtaining a prescription (1.8%).

Of the 1,410 comments analyzed, none were posted by verified healthcare providers. Titles and questions of example posts are provided (Table 3).

Discussion

The goal of this study was to analyze Reddit to gain a better understanding of the questions from patients with psoriasis regarding risankizumab, a popular monoclonal antibody medication targeting IL-23. To our knowledge, this is the first study to investigate patients’ questions regarding risankizumab on the social media site Reddit. Our results demonstrated that there is a substantial growing interest in risankizumab on psoriasis-focused Reddit platforms such as r/Psoriasis and r/Skyrizi. r/Psoriasis is currently among the top 5 percent of communities on Reddit by size. If the current rate of questions asked about risankizumab on Reddit continues until the end of 2023, the number of inquiries is on trend to nearly double from 2022 to 2023.

Patients most frequently had questions about risankizumab-related side effects. This highlights the need for physicians to better address and manage expectations regarding side effects that patients may be experiencing when taking risankizumab. Physicians could offer preemptive warnings on the most common side effects patients reported on Reddit, including flares, fatigue, and injection site reactions. Proactively informing patients of these issues could potentially ease patient anxiety, enhance adherence to the treatment, and improve the overall patient experience. Physicians may also offer advice or solutions to help address side effects, such as advising patients to rotate injection sites, inject slowly, and warm biologics at room temperature before the injection in order to minimize injection site reactions.¹⁵

The second most frequently asked question category was costs and insurance. This is a challenging aspect of healthcare to navigate for many patients, with many Reddit users expressing frustration and confusion regarding cost and insurance. The cost of biologics is increasing and the process for obtaining insurance coverage has become more difficult over recent years.¹⁶ Prior authorization denial rates for biologics increased from 0 percent in 2009 to 19 percent in 2014, with the most common reason for coverage denial being failure to attempt alternative therapies prior to beginning biologics.¹⁶ The average wait time for biologic approval was found to be approximately 30 days.¹⁷A socioeconomic barrier exists as well, with one cross-sectional study showing that patients with a lower income are less likely to use a biologic for psoriasis.¹⁸ This study highlights the importance of addressing risankizumab cost and insurance barriers by discussing prior authorization requirements and timelines. One valuable way for physicians to help address this barrier to care is by informing patients about the Skyrizi Complete program, where patients can obtain risankizumab at discounted prices and receive insurance assistance from Nurse Ambassadors. Nurse Ambassadors may also help with Skyrizi usage instructions, which is another common area patients have questions about on Reddit.

Our results are consistent with other studies that have analyzed psoriasis-related content on social media. One study that examined YouTube, Instagram, and TikTok found that 46.4 percent of patients with psoriasis described biologics as “burdensome,” with the most cited reasons being adverse effects or abnormal blood tests (12.8%) and cost or insurance issues (11.7%).¹⁹ Another cross-sectional study examining YouTube videos relating to psoriasis biologics found that while most videos were in favor of biologics (80%), many acknowledged cost, side effects, and pain at injection sites as potential issues.²⁰

This study highlights an underutilized yet crucial opportunity for physicians to engage in healthcare. It is notable that out of the 1,410 comments analyzed, none were posted by verified healthcare providers. This is significant because Reddit does not have a peer review process that can check the quality and accuracy of information posted. Patients are increasingly using social media to obtain their healthcare information, with one study showing that 80.5 percent of patients with psoriasis regularly or sometimes use social media or the internet to seek information about psoriasis.²¹ While Reddit and other social media platforms are a valuable way for patients to share experiences and obtain healthcare information, we must be aware of the potential spread of misinformation. For example, 72 percent of Facebook users stated that they had searched for disease-related information on Facebook, with 60 percent of these users reporting unreliable information.²² Additionally, one study found that 21 percent of psoriasis-related videos on YouTube were misleading.²³ Another study showed that out of all psoriasis biologics-related videos on YouTube, videos made by healthcare professionals had fewer views.²⁰ There is also a challenge in addressing patient misinformation as many patients may not freely admit they are following medical advice they obtain online. One study found that 78.7 percent of patients with psoriasis state they did not share with their physicians that they obtained information about their disease from the internet.²¹ It is crucial for dermatologists to be aware of the online discourse concerning risankizumab, so that they may use social media to better understand patient concerns and potentially enhance health outcomes.

Conclusion

Our study has demonstrated the value of analyzing online platforms such as Reddit to better understand the informational needs and concerns of patients undergoing treatment for psoriasis, specifically for those taking risankizumab. The study presents a distinct approach by harnessing the power of social media data to understand patient perspectives, which may not be readily apparent in clinical settings. This information may guide physicians to better understand patient experiences and provide more tailored clinical guidance. A strength of this study is that we used Reddit to directly access patients’ firsthand experiences, opinions, and questions about risankizumab. The anonymous nature of Reddit allows us to uncover genuine patient concerns, offering perspectives that may be missed in clinical settings. One limitation of this study is that Reddit users may not be representative of the overall psoriasis population. Additionally, as Reddit users are largely anonymous, the authenticity of patient experiences and questions cannot be fully confirmed. Further research is needed to evaluate the accuracy of risankizumab and other psoriasis information on Reddit and its impact on patient outcomes.

Data availability statement. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Competing interests statement. The authors declare no competing interests.

References

1. Armstrong AW, Mehta MD, Schupp CW, et al. Psoriasis prevalence in adults in the United States. JAMA Dermatol. 2021;157(8):940–946.
2. Bhosle MJ, Kulkarni A, Feldman SR, et al. Quality of life in patients with psoriasis. Health Qual Life Outcomes. 2006;4:35.
3. Kim SM, Ahn J, Cho YA, et al. Increased risk of suicidality in patients with psoriasis: A nationwide cohort study in Korea. J Eur Acad Dermatol Venereol. 2023;37(1):75–84.
4. Dowlatshahi EA, Wakkee M, Arends LR, et al. The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: A systematic review and meta-analysis. J Invest Dermatol. 2014;134(6):1542–1551.
5. Kamata M, Tada Y. Efficacy and safety of biologics for psoriasis and psoriatic arthritis and their impact on comorbidities: A literature review. Int J Mol Sci. 2020;21(5):1690.
6. Gordon KB, Strober B, Lebwohl M, et al. Efficacy and safety of risankizumab in moderate-to-severe plaque psoriasis (UltIMMa-1 and UltIMMa-2): Results from two double-blind, randomised, placebo-controlled and ustekinumab-controlled Phase 3 trials. Lancet. 2018;392(10148):650–661.
7. Drugs.com. Skyrizi FDA approval history. Updated 19 Jun 2024. Accessed 3 Mar 2025. https://www.drugs.com/history/skyrizi.html
8. Armstrong AW, Soliman AM, Betts KA, et al. Comparative efficacy and relative ranking of biologics and oral therapies for moderate-to-severe plaque psoriasis: A network meta-analysis. Dermatol Ther (Heidelb). 2021;11(3):885–905.
9. Pew Research Center. Social media usage: 2005–2015. 8 Oct 2025. Accessed 19 Jul 2023. https://www.pewresearch.org/internet/2015/10/08/social-networking-usage-2005-2015/.
10. Chen J, Wang Y. Social media use for health purposes: Systematic review. J Med Internet Res. 2021;23(5):e17917.
11. Gantenbein L, Navarini AA, Maul LV, et al. Internet and social media use in dermatology patients: Search behavior and impact on patient-physician relationship. Dermatol Ther. 2020;33(6):e14098.
12. Backlinko. Reddit user and growth stats. Updated 21 Jan 2025. Accessed 3 Mar 2025. https://backlinko.com/reddit-users.
13. Idriss SZ, Kvedar JC, Watson AJ. The role of online support communities: benefits of expanded social networks to patients with psoriasis. Arch Dermatol. 2009;145(1):46–51.
14. Litchman GH, Rigel DS. The immediate impact of COVID-19 on US dermatology practices. J Am Acad Dermatol. 2020;83(2):685–686.
15. St Clair-Jones A, Prignano F, Goncalves J, et al. Understanding and minimising injection-site pain following subcutaneous administration of biologics: a narrative review. Rheumatol Ther. 2020;7(4):741–757.
16. Abdelnabi M, Patel A, Rengifo-Pardo M, et al. Insurance coverage of biologics for moderate-to-severe psoriasis: A retrospective, observational 5-year chart review. Am J Clin Dermatol. 2016;17(4):421–424.
17. Vazquez T, Forouzandeh M, Lin D, et al. Insurance delays in the approval of biologic medications for patients with psoriasis and psoriatic arthritis. Arch Dermatol Res. 2023;315(5):1401–1403.
18. Eley SJ, DeMeo DP, Korman NJ, et al. Equity in the usage of biologics for psoriasis in the working poor. Arch Dermatol Res. 2023;315(4):1029–1031.
19. Nickles MA, Haber RN. Social media voices on the treatment of skin psoriasis with biologics. J Dermatolog Treat. 2022;33(8):3208–3209.
20. Reynolds KA, Pithadia DJ, Lee EB, et al. A cross-sectional study of YouTube videos about psoriasis biologics. Int J Dermatol. 2019;58(3):e61–e62.
21. Aslan Kayıran M, Karadağ AS, Oğuz Topal İ, et al. Habits of using social media and the internet in psoriasis patients. Dermatol Pract Concept. 2022;12(3):e2022143.
22. Schuster B, Ziehfreund S, Biedermann T, et al. Psoriasis 2.0: Facebook as a source of disease-related information for patients with psoriasis. J Dtsch Dermatol Ges. 2020;18(6):571–581.
23. Qi J, Trang T, Doong J, et al. Misinformation is prevalent in psoriasis-related YouTube videos. Dermatol Online J. 2016;22(11):13030/qt7qc9z2m5.