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Background and Importance Risankizumab is an anti-interleukin-23 monoclonal antibody used in psoriasis (PsO), psoriatic arthritis (PsA), Crohn’s disease (CD), and ulcerative colitis (UC).To evaluate treatment in a real-world setting, drug persistence (time that patients remain on the prescribed drug) is a commonly used measure. Greater drug persistence translates into a lower risk of flares, and better long-term disease control.Aim and Objectives Calculate risankizumab treatment persistence in its different indications: PsO, PsA, CD and UC.Material and Methods Observational, retrospective and descriptive study including patients with PsO, PsA, CD and UC treated with risankizumab in a tertiary care hospital from March 2021 to July 2025.The variables collected were: sex, age, diagnosis, previous treatments, start and end date of risankizumab and reason for discontinuation (primary, secondary failure, adverse reaction, loss to follow-up).Drug persistence was assessed at 6, 12, and 24 months, both overall and by indication and line of treatment (early vs later lines (>3 lines)). Excel was used for data analysis.Results A total of 113 patients were studied, the median age was 50 (16-84) years, 53.1% of whom were women. Risankizumab prescriptions were for: PsO (58.4%), CD (30.1%), PsA (10.6%), and UC (0.9%). 44.2% of patients were in the fourth-line or beyond.During the study 17.6% (n=20) discontinued treatment, with a median duration of 15 (2-28) months. Causes of discontinuation were: loss to follow-up (45%), secondary failure (35%), and primary failure (20%). No patients discontinued treatment due to intolerance.Results of drug persistence according to indication and line of treatment are shown in the following table (data UC are not shown because there is only one patient in the study and remains on treatment): Indication Treatment lines Drug Persistence 6 months 12 months 24 months PsO Earlier-lines 90% 75% 40% Later lines 96% 92% 58% PsA Earlier-lines 80% 60% 0% Later lines 71% 43% 29% CD Earlier-lines 77% 56% 0% Later lines 77% 47% 0% All indications Earlier-lines 84% 65% 25% Later lines 84% 70% 32% Conclusion and Relevance The greatest treatment persistence was observed in patients with psoriasis, whereas results regarding initiation in early or late treatment lines were contradictory. Further studies are needed to confirm these findings.Conflict of Interest No conflict of interest