Risankizumab Efficacious in Patients with Prior Plaque Psoriasis Biologic Use

Risankizumab may still be efficacious in patients with plaque psoriasis regardless of prior biologic treatments, according to a poster presentation from the American Academy of Dermatology (AAD) Annual Meeting.¹

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The drug, a systemic biologic interleukin 23 inhibitor, is already approved to treat psoriasis and psoriatic arthritis by the US Food and Drug Administration.

According to the study, patients with psoriasis who switch from one biologic to another amid treatment may experience an overall loss of efficacy. Researchers conducted a 256-week study in order to assess risankizumab’s efficacy in patients with psoriasis who have previously used biologic treatments.

The phase 3 study was placebo-controlled and double-blind for the first 0 to 52 weeks. It was also divided into 2 individual studies: UltMMa 1 and UltMMa 2.

The study included 525 participants, some of which presented with a history of biologic treatment. Examples of prior biologic treatment included biologic therapy, TNF inhibitors, and IL-17 inhibitors. Of these, 86.5% had a total of 0 prior treatment failures, 10.1% had 1 prior failure, 2.3% had 2, and 1.1% had greater than 2 prior failures. All patients self-reported information about their previous treatments and treatment reactions.

Examples of prior failures included treatment discontinuations due to a lack of efficacy, or safety and tolerability issues.

At weeks 0, 4, and every increment of 12 weeks, patients were randomly assigned to receive either 150 mg of risankizumab or the placebo treatment.

Following week 52, participants entered the open-label extension called LIMMitless, which lasted until week 256, or the study’s conclusion. Researchers continued random treatment assignments at 12 week intervals.

Researchers assessed participants using the Psoriasis Area and Severity Index (PASI) data was collected at week 256. This data was broken down into modified non-responder imputation (mNRI) and observed cases (OC).

Researchers also defined 3 types of failure: prior biologic failure, primary failure, and secondary failure. Primary failures were indicative of a lack of an initial response from participants, while secondary failures were defined as a loss of participant response.

At week 256, a range of 72.7% to 87.5% of participants with a history of biologic use had achieved a PASI score of 90.

Additionally, despite their prior biologic use, 46.4% to 46.5% of participants achieved a PASI score of 100.

No data on treatment-emergent adverse effects were listed in the poster presentation.

“After 256 weeks of continuous risankizumab treatment, a high proportion of patients with prior biologic treatment achieved clear or almost clear skin,” the study said. “Among patients who reported prior biologic failure, most patients (81.7%) achieve PASI 90 with risankizumab treatment.”

Reference

1. Crowley J, Chi-ho Hong H, Gooderman M, et al. Risankizumab efficacy for moderate-to-severe plaque psoriasis over 256 weeks in patients with prior biologic treatments. Presented at the 2023 American Academy of Dermatology Annual Meeting; March 17-21, 2023; New Orleans, LA. Accessed March 17, 2023. https://aad-eposters.s3.amazonaws.com/AM2023/poster/44102/Risankizumab+Efficacy+for+Moderate-to-Severe+Plaque+Psoriasis+over+256+Weeks+in+Patients+with+Prior+Biologic+Treatments.pdf