Highlights from

WCD 2019

World Congress of Dermatology

Milan 10-15 June 2019

Novel selective IL-23 blocker highly effective over 2 years

Results of the phase 3 IMMhance study show that more than 80% of patients continuously treated with the IL-23 inhibitor risankizumab reach complete or almost complete clearance of their psoriasis at 2 years [1].

Previously reported results from the first phase of the IMMhance trial showed that the selective IL-23 inhibitor risankizumab (n=407) met the co-primary endpoints of improvement of Psoriasis Area and Severity Index (PASI) by 90% and complete or almost complete clearance of skin lesions according to physicians global assessment (sPGA 0/1) vs placebo (n=100) (P<0.001) at week 16. The second phase (week 28 through week 104) of this trial evaluated the efficacy and safety of continuous therapy with risankizumab vs randomised withdrawal, as well as re-treatment.

Patients who achieved sPGA 0/1 at week 28 with risankizumab were re-randomised to continue either risankizumab (n=111) every 12 weeks or withdrawal (n=225). The primary endpoint of the second phase of the study was percentage of patients that reached sPGA 0/1 at 1 year. Ranked secondary endpoint was achievement of sPGA 0/1 at 2 years among re-randomised patients.

Both primary and secondary endpoints were achieved for risankizumab compared with placebo (P<0.001). Median time to relapse (sPGA > 3) was significantly different between patients re-randomised to risankizumab compared with those re-randomised to placebo (placebo 295 days vs risankizumab not determinable due to low number of relapses in this group; P<0.01). In addition, there was an increased proportion of patients treated with continuous risankizumab who achieved PASI 100 and sPGA 0 over time during the treatment period in the second phase of the trial. After 2 years, 81.1% of patients achieved sPGA 0/1. Among 153 patients re-randomised to placebo who achieved loss of response, 83.7% regained sPGA 0/1 after re-treatment with risankizumab. No new safety signals were observed over 2 years.

  1. Blauvelt A, M et al. Efficacy and safety of continuous Q12W risankizumab versus treatment withdrawal: 104 week results from the phase 3 IMMhance trial.

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