Risankizumab Clears Psoriasis in Majority of Real-World Patients at 18 Months

April W. Armstrong, MD, MPH

Persistent risankizumab (SKYRIZI) treatment may provide patient achievement of long-term psoriasis skin clearance and achievement of National Psoriasis Foundation (NPF)-based treatment goals, according to findings from a registry analysis.

In new data presented at the Fall Clinical Dermatology 2022 Annual Meeting last month, a team of US investigators supported by AbbVie reported that the marketed IL-23 inhibitor biologic therapy was associated with a majority of patients with moderate-to-severe psoriasis achieving clear skin at 18 months. The findings, accumulating through analysis of the CorEvitas Psoriasis Regsitry, provide new evidence of real-world, long-term efficacy linked to risnakizumab in patients with psoriasis.

Led by April W. Armstrong, MD, MPH, associate dean of clinical research at Keck School of Medicine at USC, investigators sought to assess the real-world state of achieved NPF-defined treatment targets, as well as skin clearance outcomes and quality-of-life metrics, linked to risankizumab in adults with moderate-to-severe psoriasis.

Armstrong and colleagues used the CorEvitas Psoriasis Registry—an independent, prospective, observational cohort comprised of adult patients with psoriasis recruited from private and academic practices across North America. The team included patients with moderate-to-severe disease per Investigator’s Global Assessment (IGA) scores ≥3 who initiated bisankizumab between April 2019 and December 2021, and had persistent use of the biologic for ≥18 months.

Investigators sought 18-month outcomes of percentage of patients achieving NPF-defined target responses—defined as body surface area (BSA) ≤1%—or acceptable response—defined as BSA ≤3% or improvement of ≥75% from baseline. They additionally sought patients’ mean improvement in BSA, IGA and Psoriasis Area Severity Index (PASI) scores at 18 months, as well as percentage of patients to achieve absolute PASI 0, ≤1 or ≤3, as well as PASI 90 or 100, or IGA 0 or 1.

Additionally, the investigators observed the percentage of patients to achieve Dermatology Life Quality Index (DLQI) scores of 0 or 1.

The team included 163 patients in the registry assessment. Mean patient age was 48.7 years old; 59.0% were male and 77.9% were White. Patients had psoriasis for a mean 17.0 years at baseline, with a mean BSA of 15.3% and PASI score of 10.2. Approximately 4 in 10 patients had no prior biologic experience; 22.1% had experience with ≥3 agents prior.

Among the registry cohort receiving risankizumab, 81.9% achieved NPF-defined target responses at 18 months; another 94.6% achieved the acceptable response per NPF. Patients reported mean improvements of 14.0 for BSA, 2.4 for IGA, and 9.1 for PASI from baseline to 18 months.

Additionally, 54.4%, 68.7% and 88.4% of patients achieved PASI 0, ≤1 and ≤3, respectively, at 18 months. A majority of patients achieved either IGA 0 (55.8%) or PASI 100 (56.4%) at 18 months, indicating clear skin. Another 73.0% and 68.1% achieved either IGA 0 or 1, or PASI 90, respectively. Approximately two-thirds (67.8%) of patients achieved DLQI 0 or 1.

Armstrong and colleagues concluded that, despite a “heavily pre-treated population in the real world,” persistent risankizumab treatment was associated with high efficacy in achieved NPF-defined metrics of psoriasis management and resolution over 18 months in adult patients.

“These results using the CorEvitas Psoriasis Registry provide evidence of real-world long-term risankizumab effectiveness in patients with psoriasis,” they wrote.

The study, “Real-World Effectiveness of Persistent Risankizumab Treatment in Patients With Moderate-to-Severe Psoriasis From the CorEvitas Psoriasis Registry,” was presented at Fall Clinical Dermatology 2022.