Risankizumab Significantly Reduces Severity of Psoriasis Symptoms

Risankizumab (Skyrizi; AbbVie), an Il-23 inhibitor, improved clinical response in patients with moderate-to-severe non-pustular palmoplantar psoriasis, according to the authors of an abstract at the American Academy of Dermatology Annual Meeting presented in San Diego, California.

“The robust evidence from this trial demonstrates the significant efficacy of risankizumab when administered to patients sooner in their treatment journey,” said Linda Stein Gold, MD, director of Research, Head of Division of Dermatology for Henry Ford Health System, to Pharmacy Times.

Risankizumab is indicated for the treatment of moderate to severe psoriasis. Investigators conducted the phase 3b randomized, double-blind, placebo controlled IMMprint (NCT04713592) study to evaluate risankizumab for improving palmoplantar psoriasis area and severity index (PPASI) and psoriasis area and severity index (PASI) in patients aged 18 years and older who have moderate-to-severe non-pustular palmoplantar psoriasis.

Investigators evaluated risankizumab on improving palmoplantar psoriasis area and severity index (PPASI) and psoriasis area and severity index (PASI) in patients aged 18 years and older who have moderate-to-severe non-pustular palmoplantar psoriasis. Image Credit: © Dragana Gordic - stock.adobe.com

Patients were randomized 1:1, receiving either a 150 mg dose of risankizumab at baseline, week 4, and week 16, or placebo. At 16 weeks, every patient was eligible to receive open label risankizumab (150mg) every 12 weeks till week 40.

At week 16, risankizumab led to a significant reduction in PPASI score compared to placebo—patients on risankizumab experienced an average decrease of 11.3 points compared to patients on placebo (6.1-point decrease; p < 0.001).

There was also a final evaluation of PPASI and PASI at week 52. Patients who took risankizumab for the entire trial had a reduction in PPASI by 16.9 points, while those who switched from placebo to risankizumab experienced a 17.2 point drop.

Risankizumab also led to a significant percent decrease in PPASI score compared to placebo. At week 16, patients on risankizumab experienced an average drop of 51.8% in palmoplantar psoriasis severity from baseline, while the decrease in symptom severity was 27.6% among patients on placebo (p <0.001).

By week 52, patients treated with risankizumab from baseline to week 40 experienced a 76.1% reduction in severity from baseline on the PPASI. Patients who took placebo until week 16 and risankizumab from week 16 to week 40 experienced a 78.7% change in severity from baseline on the PPASI.

PASI change from baseline was 7.6 points with risankizumab and 2.3 points with placebo (p < 0.001) at week 16. At 52 weeks, the risankizumab arm experienced a 10.3-point reduction in PASI score, while the placebo-turned-risankizumab arm experienced a 9.4 point reduction.

Finally, patients on risankizumab experienced a 68.1% change in PASI from baseline to week 16, while those on placebo experienced a 15.9% change (p < 0.001). At week 52, patients on risankizumab alone experienced an 89.7% reduction on PASI, and patients who switched from placebo to risankizumab experienced an 87.1% reduction in severity from baseline. Investigators did not report any new safety signals.

“Both findings are important for physicians and their patients to consider when discussing a treatment plan,” Gold said.

REFERENCE

Safety and efficacy of risankizumab in adult patients with moderate to severe plaque psoriasis with palmoplantar (nonpustular) involvement: change in PASI and PPASI from phase 3b IMMprint trial. Abstract. American Acadamy of Dermatology Annual Meeting. March 8 to 12, 2024.