In a cohort study of 61 patients prescribed risankizumab (RZB) for Crohn's Disease more frequently than the FDA approved dose, almost half had improvement. There was a trend suggesting patients who failed multiple advanced therapies were less likely to improve. A third (33%) of patients had additional medication changes. With available data, improvements were seen in CRP (54%), ESR (46%), and HBI (56%) measures. This study provides the largest cohort of escalated dosing in RZB.