A study published in Dermatology and Therapy has shown that switching to risankizumab is an effective treatment option for patients with moderate to severe plaque psoriasis who are not responding adequately to other IL-17 inhibitors, such as secukinumab and ixekizumab. The findings suggest that risankizumab not only improves clinical outcomes but also enhances patients’ quality of life.
The research, part of a phase 3b, multicenter, open-label trial (aIMM; ClinicalTrials.gov Identifier: NCT04102007), evaluated the safety and efficacy of switching patients who had experienced inadequate responses to secukinumab or ixekizumab for six months or longer. The study involved 244 adult patients from eight countries, all of whom had plaque psoriasis with a static Physicians Global Assessment (sPGA) score of 2 or 3 and a body surface area (BSA) affected by 3% to 10%. These patients were administered risankizumab 150 mg at weeks 0 and 4, followed by injections every 12 weeks for a total of 52 weeks.
The primary endpoint of the study was the proportion of patients who achieved an sPGA score of 0 or 1 (clear or almost clear skin) at week 16. Results showed that 57.4% of patients reached this goal at week 16. Furthermore, 20.5% of patients achieved complete clearance (sPGA 0), while 40.2% had a Dermatology Life Quality Index (DLQI) score of 0/1, indicating minimal impact on their quality of life. Additionally, 20.9% of patients achieved a Psoriasis Symptoms Scale (PSS) score of 0, indicating minimal symptoms.
At week 52, the response rates improved. A total of 62.3% of patients achieved an sPGA score of 0/1, with 27.1% of patients reaching complete clearance (sPGA 0). Furthermore, 47.2% of patients had a DLQI score of 0/1, and 27.5% achieved a PSS score of 0. Notably, 47.9% of those who had an sPGA 0/1 response at week 16 maintained this improvement at week 52.
The study also revealed that patients who previously received secukinumab had higher response rates compared to those who had been treated with ixekizumab. Specifically, 69.1% of patients who had been treated with secukinumab achieved an sPGA score of 0/1 at week 52, compared to 51.6% of those who had received ixekizumab.
Regarding safety, treatment-emergent adverse effects (TEAEs) occurred in 67.2% of patients, with 19.7% of these being possibly related to the study treatment. Severe and serious adverse events were reported in 7.4% and 7.0% of patients, respectively. The most common TEAEs included COVID-19 (8.6%) and nasopharyngitis (5.7%).
However, the study’s open-label, single-arm design and the limited diversity in patient ethnicity represent notable limitations. Despite these constraints, the investigators concluded that risankizumab offers a promising treatment alternative for patients with moderate to severe plaque psoriasis who have not responded sufficiently to secukinumab or ixekizumab, citing its efficacy, safety profile, and improvement in quality of life.
These findings underscore risankizumab as a valuable option for those seeking effective treatment for psoriasis, particularly for patients who have not achieved optimal results with other IL-17 inhibitors.
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