Ken Gordon, MD: Clinical Implications of the UltIMMa Trials of Risankizumab

The UltIMMa trials of risankizumab for patients with plaque psoriasis demonstrated efficacy and safety. In an interview with MD Magazine®, Ken Gordon, MD, Professor and Chair of Dermatology, Medical College of Wisconsin, Milwaukee, spoke about the study results and their implications for both prescribers and patients.

Gordon noted the efficacy of risankizumab and highlighted the strong safety outcomes. “Well, the safety story is best because there's really no story and that's the best part of it—there really isn't any signal that we can see in the clinical trials for safety,” he said.

The poster, “Efficacy and Safety of Risankizumab in Moderate-to-Severe Plaque Psoriasis: An Integrated Analysis of UltIMMa-1 and UltIMMa-2,” was shared at the AAD Annual Meeting, held March 1-5, 2019. Here is part 1 of his interview.

MD Mag: What do these results mean for clinicians and patients with psoriasis?

Gordon: So, always there's 2 sides to any medication, and it's both efficacy and safety—and then there's the lesser, but still significant considerations of things like convenience and ease of use, which are, for patients, huge issues. The safety—and there are a number of posters here which are looking at integrated data sets and also comparison to other agents, not only ustekinumab, but also adalimumab and placebo in terms of safety—and that safety message is... Well, the safety story is best because there's really no story and that's the best part of it—there really isn't any signal that we can see in the clinical trials for safety. So, for patients who you think about—okay here you have a drug that's, I would believe is relatively convenient, it's basically going to be a shot [2 subcutaneous injections] 4 times a year [following initial doses at week 0 and week 4], which most patients find pretty acceptable in comparison to taking a pill multiple times a day or getting more frequent injections, and then you have a safety record that doesn't preclude you from using the medication in any number of patients, and then finally, having something I can write for a medication and reasonably predict that you're going to be doing well for an extended period of time. There's a level of comfort that goes in for the patient, that they don't have to worry about the disease, the idea is we're taking the disease and making it so it's not part of their lives for a little bit.

One thing that's really interesting in looking at psoriasis trials is patients early on when they get high level responses never completely trust that their disease is under control, there's always a sense that it's going to be coming back. And over time you look at life quality indices and things of that sort and impact of the disease on individuals, [you see] that they become more comfortable and they become more willing to go into the activities that you and I would take for granted. So, that persistence is really something that, if we can say we're going to be on something and then be able to stay on it and you're not going to have issues that are going to force you to deal with the disease coming back or that there's going to be a safety issue that going to be different from what you would see just in your everyday life—you can give patients some level of comfort that they're going to be able to go on a lead a more normal life in respect to the disease.