Real-World Risankizumab Durability in High-Impact Psoriasis, With Tina Bhutani, MD, MAS

Three-year real-world data from the VALUE study support durable responses with risankizumab (Skyrizi) in patients with plaque psoriasis involving high-impact areas, according to Tina Bhutani, MD, MAS, FAAD, president and CEO of Synergy Dermatology in San Francisco, California, and associate adjunct professor of dermatology at the University of California, San Francisco.

In an interview with HCPLive, Bhutani discussed the findings and her approach to choosing systemic therapy.

The analysis was presented at the 2026 European Academy of Dermatology and Venereology (EADV) Congress in Vienna, Austria, held September 30 to October 3.1 VALUE (NCT03982394) is a multi-country, prospective, post-marketing observational study comparing risankizumab with other approved biologics in moderate to severe plaque psoriasis. The data add to 52-week UnlIMMited results in genital and scalp psoriasis discussed at the same congress.

“The paradigm really is changing. These patients with moderate disease, they do have significant uncontrolled inflammation. They are still at risk for developing comorbidities, things like psoriatic arthritis, and so I really do think that we should not really separate patients into these 2 categories,” Bhutani said.

Bhutani said the 3-year results mirror the efficacy and safety seen in the pivotal trials and show patients with clear skin at year 1 maintaining it through year 3, including in sites slower and harder to clear. In a published 25-month interim analysis of 2,639 patients, PASI 100 rates were 56.6% with risankizumab vs 40.2% with other biologics, and Dermatology Life Quality Index 0/1 rates were 70.0% vs 52.9% (nominal P < .0001 for both).2

Oral options have grown more effective, Bhutani said, but biologics remain the fastest and most effective agents available for psoriasis, so she tends to favor them in the exam room.

Bhutani opens the systemic therapy conversation earlier when Dermatology Life Quality Index scores show high burden or lesions involve the scalp, nails, palms, or soles, even with limited body surface area. She cited maintenance dosing every 12 weeks, or 4 injections a year, as a strong factor for busy patients, provided efficacy and safety match the convenience.

Well-designed real-world studies capture patients with comorbidities and concomitant medications often excluded from randomized trials, Bhutani said. She encouraged clinicians to use shared decision-making while advocating for the most effective treatment regardless of body surface area.

References

1. Real-world effectiveness of risankizumab versus other biologic therapies after 3 years of treatment in adults with moderate-to-severe plaque psoriasis with high-impact area involvement [poster P2617]. In: AbbVie showcases leadership in dermatology research with new clinical and real-world evidence across immune-mediated skin diseases at 2026 EADV Congress. News release. AbbVie. September 30, 2026. Accessed October 12, 2026. https://news.abbvie.com/2026-09-30-AbbVie-Showcases-Leadership-in-Dermatology-Research-With-New-Clinical-and-Real-World-Evidence-Across-Immune-Mediated-Skin-Diseases-at-2026-EADV-Congress

2. Thaçi D, Ohtsuki M, Maul JT, et al. Real-world effectiveness of risankizumab in patients with moderate-to-severe psoriasis: interim analysis from the VALUE global prospective post-marketing observational study at 25 months. Dermatol Ther (Heidelb). 2025;15(2):381-394. doi:10.1007/s13555-025-01342-0. https://pubmed.ncbi.nlm.nih.gov/39904971/