Risankizumab More Effective, Durable Than Ustekinumab in Moderate-to-Severe Psoriasis

March 10, 2019

By Marielle Fares, PharmD

Washington, DC -- March 8, 2019 -- In patients with moderate-to-severe psoriasis, risankizumab shows superior efficacy to ustekinumab after 52 weeks of treatment, according to an integrated analysis of the phase 3 UltlMMa-1 and UltlMMa-2 trials presented here at the 2019 Annual Meeting of the American Academy of Dermatology (AAD).

Peter Foley, MD, FACD, The University of Melbourne, St. Vincent’s Hospital, and Probity Medical Research, Skin and Cancer Foundation, Inc., Melbourne, Australia, presented the study on March 2.

Dr. Foley and colleagues randomised patients with moderate-to- severe psoriasis in a 3:3:1 fashion to receive risankizumab 150 mg (n = 598), ustekinumab 45 or 90 mg (n = 199), or placebo (n = 200).

In part A of the study (weeks 0-4), patients received injections at 0, 4, 16, 28, and 40 weeks. At 16 weeks, patients receiving placebo were switched to risankizumab 150 mg. In part B (weeks 16-52), patients received risankizumab or ustekinumab at 16, 28, and 40 weeks.

Risankizumab-treated patients scored significantly higher on the PASI90 (the percentage of patients who have achieved a ≥90% reduction in Psoriasis Area and Severity Index score from baseline) and Static Physicians Global Assessment (sPGA) clear or almost clear (sPGA 0/1) efficacy measures than ustekinumab-treated patients (P

At week 52, the proportion of patients achieving PASI90 and sPGA 0/1 was significantly higher among patients receiving risankizumab than patients receiving ustekinumab.
PASI90 range was 77.6% to 85.9% in the risankizumab group versus 30.8% to 56.3% in the ustekinumab group, and the sPGA 0/1 range was 79.5% to 90.6% versus 39.4% to 65.2 %, respectively.

Importantly, the results were consistent across all patient subgroups, including baseline demographics (age, sex, race, smoking status, body mass index), disease characteristics (baseline PASI and sPGA score, presence of psoriatic arthritis), and prior biologic response. This study supports the use of risankizumab in moderate-to-severe psoriasis across several patient populations, the researchers concluded.

No new safety signals were seen in this study, and the adverse-event profile was similar in the risankizumab and ustekinumab groups.

The amount of previous biologic therapy was similar in both groups; baseline mean PASI scores and body-surface involvement were similar in both patient groups as well.

Funding for this study was provided by AbbVie, Inc., North Chicago, Illinois.

[Presentation title: Durable Efficacy of Risankizumab Compared With Ustekinumab Across Subgroups of Patients With Moderate-to-Severe Plaque Psoriasis: Integrated Analysis of Two Phase 3 Trials. Abstract 9780]