Risankizumab Effective for Psoriasis Over 18 Months in Real World Settings

Risankizumab is durable and efficacious in real-world settings among individuals with moderate-to-severe psoriasis (PsO), according to a new retrospective study, as continual improvements were observed in patients’ severity of disease and symptoms over 18 months.¹

These phase 3 data were the conclusion of a retrospective medical chart review analysis that assessed data from patients out of Germany, Poland, Japan, Czech Republic, and Canada. This research was led by Andreas Pinter, MD, from the University Hospital Frankfurt am Main department of dermatology in Frankfurt am Main, Germany.

While there is substantial research on risankizumab’s efficacy, including comparisons to secukinumab and adalimumab, Pinter et al. noted the lack of real-world data on patient outcomes after treatment with the drug, especially internationally.^2,3

“Thus, this study sought to describe characteristics and clinical outcomes of patients with PsO using data collected from the RisAnkizumab for the treatment of moderate-to-severe Psoriasis—An International meDical chart review (RAPID) study, which recruited physicians from an existing panel of dermatologists in Canada, the Czech Republic, Germany, Japan, and Poland,” Pinter and colleagues wrote.

Background and Methods

The investigators conducted their retrospective analysis across the aforementioned countries, with data collection being initiated in September 2022 regarding adult subjects diagnosed with psoriasis who had a minimum of 3 years' treatment experience and dermatologists with direct access to medical records.

Participants would be included if they had been treated with risankizumab on or following January 2019, if they had medical records that were available for 12 months at least following the index date, and if they had medical records which spanned at least half a year before the index date. The index date was defined by the research team as the date when their therapy began.

All subjects also were required to have had a baseline Investigator Global Assessment (IGA) or static Physician’s Global Assessment (sPGA) score of 3 or higher in order to be included, as well as a minimum of 3 recorded scores for IGA, Psoriasis Area and Severity Index (PASI), or sPGA. They also needed at least a single Dermatology Life Quality Index (DLQI) score recorded within 3 months prior to their index date and at least a single recorded DLQI score within 18 months following the index date.

Several different endpoints were evaluated by the team including the proportion of individuals reporting clear/almost clear psoriasis levels (IGA/sPGA = 0/1), DLQI = 0/1, PASI ≤ 1, a 90% or 100% PASI score improvement from the point of baseline. They also looked at mean changes in PASI, pruritus, DLQI, and skin pain scores at the 12 and 18-month time points.

Findings

The investigators reported that 74.0% of the subjects reported no previous exposure to biologic therapy, 66.4% of those featured in the research had been male, and 73.0% had been shown to have scalp psoriasis. The average baseline scores shown at the start of the study for subjects’ IGA/sPGA scores were found to be 3.7 ± 0.5, and for PASI, 23.3 ± 11.8.

The research team found that, over the 12 months they had analyzed, 86.1% of subjects were shown to have an IGA/sPGA score ≤1, and 75.7% were shown to have achieved PASI90. The team noted that these figures had risen to 91.1% and 80.5%, respectively, by the 18-month mark, adding that there had also been significant improvements in subjects’ itch, DLQI, and skin pain scores.

“A limitation of this analysis is that it only included those patients who were receiving treatment by experienced dermatologists and thus may not be fully generalizable to a larger PsO population,” they wrote. “While non-random chart selection may introduce sampling bias, we aimed to minimize this through the implementation of a randomization tool that was used as part of the data collection process.”

References

1. ^{Pinter, A., Soliman, A.M., Pivneva, I. et al. Real-World Long-Term Effectiveness of Risankizumab Among Patients with Moderate-to-Severe Psoriasis: Analysis from an International Medical Chart Review (RAPID) Study. Dermatol Ther (Heidelb) (2024). https://doi.org/10.1007/s13555-024-01164-6.}
2. ^{Reich K, Gooderham M, Thaci D, Crowley JJ, Ryan C, Krueger JG, et al. Risankizumab compared with adalimumab in patients with moderate-to-severe plaque psoriasis (IMMvent): a randomised, double-blind, active-comparator-controlled phase 3 trial. Lancet. 2019;394(10198):576–86.}
3. ^{Warren RB, Blauvelt A, Poulin Y, Beeck S, Kelly M, Wu T, et al. Efficacy and safety of risankizumab vs. secukinumab in patients with moderate-to-severe plaque psoriasis (IMMerge): results from a phase III, randomized, open-label, efficacy-assessor-blinded clinical trial. Br J Dermatol. 2021;184(1):50–9.}