Spotlight on risankizumab and its potential in the treatment of plaque psoriasis: evidence to date

Figures & data

Figure 1 Summarized schematic differences between IL-12/23-p40, IL-23p19, and IL-17 blockade.

Notes: IL-12/23p40 inhibitors, such as ustekinumab, block IL-12 and IL-23 common subunit p40, inhibiting both IL-23/Th17 and IL-12/Th1 pathways; IL-23p19 inhibitors, such as risankizumab, guselkumab, and tildrakizumab, selectively block the IL-23/T17 pathway, avoiding effects on the IL-12/Th1 axis; IL-17A inhibitors, such as secukinumab and ixekizumab, also target the IL-23/IL-17 axis, although through downstream blockade of this pathway.
Abbreviations: DC, dendritic cell; INF-γ, interferon gamma; KC, keratinocyte; Th1 and Th17, T-helper cell 1 and 17; TNF-α, tumor necrosis factor alpha.

Table 1 Summary of key results from clinical trials of risankizumab

Clinical trial	Dosing regimen	Proportion of patients achieving
		PASI 50	PASI 75	PASI 90	PASI 100	sPGA 0/1	sPGA 0	PSS 0
Phase II study (Papp et al^Citation22)	18-mg single dose of risankizumab at week 0; or 90-mg or 180-mg doses of risankizumab or 45-mg or 90-mg doses of ustekinumab based on weight (≤100 kg vs >100 kg), at weeks 0, 4, and 16	At week 12 Risankizumab: 18-mg: 86.0% 90-mg: 100.0% (P<0.001) 180-mg: 92.9% Ustekinumab: 82.5%	At week 12 Risankizumab: 18-mg: 62.8% 90-mg: 97.6% (P<0.001) 180-mg: 88.1% Ustekinumab: 72.5% At week 24 Risankizumab: 18-mg: 53.0% 90-mg: 90.0% 180-mg: 88.0% Ustekinumab: 70.0%	At week 12 Risankizumab: 18-mg: 30.2% 90-mg: 73.2% (P<0.001) 180-mg: 78.6% (P<0.001) Ustekinumab: 40.0% At week 24 Risankizumab: 18-mg: 28.0% 90-mg: 63.0% 180-mg: 81.0% Ustekinumab: 55.0%	At week 12 Risankizumab: 18-mg: 13.9% 90-mg: 41.5% (P<0.001) 180-mg: 47.6% (P<0.001) Ustekinumab: 17.5%	At week 12 Risankizumab: 18-mg: 58.1% 90-mg: 90.2% (P<0.001) 180-mg: 88.1% (P<0.001) Ustekinumab: 62.5%	Not reported	Not reported
UltIMMa-1	Part A: 150-mg dose of risankizumab, 45-mg or 90-mg doses of ustekinumab based on weight (≤100 kg vs >100 kg), or placebo, at weeks 0 and 4 Part B: Patients initially assigned to placebo switched to 150 mg risankizumab at week 16	Not reported	At week 12 Risankizumab: 86.8% Ustekinumab: 70.0% (P=0.0005) Placebo: 9.8% (P<0.0001) Placebo to risankizumab: NA	At week 16 Risankizumab: 75.3% Ustekinumab: 42.0% (P<0.0001) Placebo: 4.9% (P<0.0001) Placebo to risankizumab: NA At week 52 Risankizumab: 81.9% Ustekinumab: 44.0% (P<0.0001) Placebo: NA Placebo to risankizumab: 78.4%	At week 16 Risankizumab: 35.9% Ustekinumab: 12.0% (P<0.0001) Placebo: 0% (P<0.0001) Placebo to risankizumab: NA At week 52 Risankizumab: 56.3% Ustekinumab: 21.0% (P<0.0001) Placebo: NA Placebo to risankizumab: 54.6%	At week 12 Risankizumab: 82.2% Ustekinumab: 65.0% (P=0.0007) Placebo: 8.8% (P<0.0001) Placebo to risankizumab: NA At week 16 Risankizumab: 87.8% Ustekinumab: 63.0% (P<0.0001) Placebo: 7.8% (P<0.0001) Placebo to risankizumab: NA	At week 16 Risankizumab: 36.8% Ustekinumab: 14.0% (P<0.0001) Placebo: 2.0% (P<0.0001) Placebo to risankizumab: NA At week 52 Risankizumab: 57.6% Ustekinumab: 21.0% (P<0.0001) Placebo: NA Placebo to risankizumab: 54.6%	At week 16 Risankizumab: 29.3% Ustekinumab: 15.0% (P=0.0010) Placebo: 2.0% (P<0.0001) Placebo to risankizumab: NA
UltIMMa-2		Not reported	At week 12 Risankizumab: 88.8% Ustekinumab: 69.7% (P<0.0001) Placebo: 8.2% (P<0.0001) Placebo to risankizumab: NA	At week 16 Risankizumab: 74.8% Ustekinumab: 47.5% (P<0.0001) Placebo: 2.0% (P<0.0001) Placebo to risankizumab: NA At week 52 Risankizumab: 80.6% Ustekinumab: 50.5% (P<0.0001) Placebo: NA Placebo to risankizumab: 85.1%	At week 16 Risankizumab: 50.7% Ustekinumab: 24.2% (P<0.0001) Placebo: 2.0% (P<0.0001) Placebo to risankizumab: NA At week 52 Risankizumab: 59.5% Ustekinumab: 30.3% (P<0.0001) Placebo: NA Placebo to risankizumab: 67.0%	At week 12 Risankizumab: 82.3% Ustekinumab: 64.6% (P=0.0006) Placebo: 9.2% (P<0.0001) Placebo to risankizumab: NA At week 16 Risankizumab: 83.7% Ustekinumab: 61.6% (P<0.0001) Placebo: 5.1% (P<0.0001) Placebo to risankizumab: NA	At week 16 Risankizumab: 51.0% Ustekinumab: 25.3% (P<0.0001) Placebo: 3.1% (P<0.0001) Placebo to risankizumab: NA At week 52 Risankizumab: 59.5% Ustekinumab: 30.3% (P<0.0001) Placebo: NA Placebo to risankizumab: 67.0%	At week 16 Risankizumab: 31.3% Ustekinumab: 15.2% (P=0.0003) Placebo: 0% (P<0.0001) Placebo to risankizumab: NA

Note: Nonresponder imputation was used to assess binary endpoints missing data.

Abbreviation: NA, not applicable.

PappKABlauveltABukhaloMRisankizumab versus ustekinumab for moderate-to-severe plaque psoriasisN Engl J Med2017376161551156028423301

 PubMed Web of Science ®Google Scholar