"These findings may further raise standards for treatments and provide promising outcomes for patients suffering from moderate to severe chronic plaque psoriasis," researchers write in JAMA Dermatology.
Dr. Kenneth B. Gordon of the Medical College of Wisconsin, in Milwaukee, and colleagues combined data from the UltIMMa-1 and -2 trials, which compared risankizumab versus ustekinumab or placebo in patients with moderate to severe psoriasis, to evaluate patient-reported outcomes that were included in the studies as secondary endpoints.
Risankizumab, an interleukin (IL)-23 inhibitor, is approved in the U.S. and Europe.
After treatment, patients in the risankizumab group had significantly lower Psoriasis Symptom Scale (PSS) scores than did patients in the placebo and ustekinumab groups.
At week 16, significantly more patients treated with risankizumab (181/598, 30.3%) than with ustekinumab (30/199, 15.1%) or placebo (2/200, 1.0%) were free of psoriasis symptoms (PSS = 0) and had Dermatology Life Quality Index scores indicating no impact on skin-related health-related quality of life (66.2% vs. 44.7% and 6.0%, respectively).
Similarly, a significantly greater proportion of patients treated with risankizumab had meaningful improvements in EuroQoL-5D generic quality of life scores.
At week 16, significantly more patients treated with risankizumab also experienced improvements in anxiety and depression.
The authors caution, however, that the generalizability of the study results may be limited because patients enrolled in clinical trials may differ from those in clinical practice.
Dr. Alexander Egeberg of Gentofte Hospital, in Hellerup, Denmark, who recently reviewed first-line biologic treatments for moderate to severe psoriasis, told Reuters Health by email, "Ustekinumab has been a consistent 'go-to' drug for many years, due to its favorable safety profile, good efficacy, and the long adherence to treatment for people treated with this drug. However, real-world data have shown that many patients still have impaired quality of life and experience symptoms, such as itch and skin pain, even if they are clear or almost clear of their psoriasis."
"The considerable improvement that was seen with risankizumab (already in the early weeks of the trial) suggests that we now have a therapy that not only provides an extraordinary level of skin clearance, but also provides a very high and consistent level of symptom relief for patients treated with risankizumab," he said.
"In recent years, we have been blessed with a number of therapies that are efficacious in clearing the visible signs of psoriasis," said Dr. Egeberg, who was not involved in the new analysis. "However, the data presented in this article provides further arguments to the discussion of whether we should move towards a more holistic treatment approach, where 'freedom from disease' is the goal rather than skin clearance alone."
AbbVie funded the studies and employed several of the authors.
Dr. Gordon was not available for comments.
By Will Boggs MD
SOURCE: https://bit.ly/34eV6HV JAMA Dermatology, online October 14, 2020.
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