Risankizumab remains effective for long-term treatment of psoriasis

Even after five years of continuous treatment, risankizumab continues to be effective in treating moderate to severe plaque psoriasis. Results are particularly encouraging for patients with nail, scalp and palmoplantar psoriasis, according to an extension study published in January.Risankizumab is an interleukin 23 (IL-23) inhibitor available as a 150 mg subcutaneous injection. It was approved by Health Canada in 2019 for the treatment of moderate to severe plaque psoriasis in adult patients. To verify its long-term effects, participants had to first complete one of two randomized 52-week-long Phase III studies called UltIMMa-1 and UltIMMa-2. They received an injection at baseline, at four weeks and every 12 weeks thereafter. Participants could then continue in the study over the long term if they wanted to, receiving an injection every 12 weeks until they reached 256 weeks, which translates into almost five years of treatment. The researchers assessed efficacy by recording the proportion of patients achieving a 90% or 100% reduction in the Psoriasis Area and Severity Index (PASI 90/100). The number of patients achieving PASI 90 or PASI 100 after 52 weeks was similar to the number after 256 weeks, irrespective of age, gender or presence of psoriatic arthritis.Clinical response was comparable and durable between subgroups based on body weight or BMI. Results from other studies of the efficacy of psoriasis treatments suggested a reduced response rate in patients with a higher BMI, but this was not observed in this study.Read: U.S. guidelines focus on topical therapies for vitiligo in children and young adultsThe results offer a glimmer of hope for patients with nail, scalp or palmoplantar psoriasis. Psoriasis in these areas is known to be more complex to treat, in addition to being associated with pain, functional limitations and poorer quality of life. “Topical treatments are generally ineffective, not well tolerated, or are cosmetically unacceptable for nail, scalp and palmoplantar psoriasis; some systemic therapies have demonstrated therapeutic benefits, but more clinical studies are needed,” the researchers wrote in their paper.After five years of treatment, patients with nail lesions achieved Nail Severity Psoriasis Index (NAPSI) of zero in 66% of cases, with an average improvement of more than 81% compared to the start of treatment. As for scalp psoriasis (which affected almost all participants), the absence of lesions (Psoriasis Scalp Severity Index of zero) was observed in 73% of cases after five years, with an average improvement of 94%. Patients with psoriasis on the palms or soles of the feet saw a total disappearance of erythema and desquamation (Palmoplantar Psoriasis Area and Severity Index of zero) in 81% of cases after 256 weeks. The average improvement from baseline was 97%.Almost a quarter of participants had plaque psoriasis in these three areas. A simultaneous disappearance of plaque psoriasis in these three areas was observed in 44.6% of these patients at the end of the five years of treatment.The study was published in the Journal of the European Academy of Dermatology and Venereology.Read: Management options in patients with atopic dermatitis refractory to topical therapiesThis article was translated from French and originally ran in our sister publication Profession Santé.

Risankizumab remains effective for long-term treatment of psoriasis

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