Efficacy of Risankizumab versus Secukinumab in Patients with Moderate-to-Severe Psoriasis: Subgroup Analysis from the IMMerge Study

Abstract

Introduction: Patients with moderate-to-severe plaque psoriasis who experience poor clinical outcomes, including patients with obesity or prior treatment, need improved treatment options. Risankizumab specifically inhibits interleukin 23 and has demonstrated superior efficacy in active-comparator studies in patients with moderate-to-severe plaque psoriasis. We compared the efficacy of risankizumab with that of secukinumab across patient subgroups.

Methods: Subgroup analyses using data from the phase 3 IMMerge study (NCT03478787) were performed. Efficacy in adults with moderate-to-severe psoriasis treated with risankizumab 150 mg and secukinumab 300 mg was assessed as the proportion of patients who achieved ≥ 90% improvement in Psoriasis Area Severity Index (PASI 90) at week 52 across demographics and disease characteristics. Post hoc analyses evaluated the proportion of patients who achieved PASI 90 and the least-squares mean percent PASI improvement from baseline at week 52 by body weight and body mass index (BMI), PASI 90 by prior treatment, and clinical response [PASI 90, PASI 100, and/or static Physician's Global Assessment (sPGA) score of clear (0) or almost clear (1)] at week 16 and maintained particular response at week 52. Logistic regression analyses examined the effect of covariates (age, sex, BMI, baseline PASI, treatment) and potential interactions on PASI 90 at week 52.

Results: More patients who received risankizumab (n = 164) compared with secukinumab (n = 163) achieved PASI 90 at week 52, regardless of demographics and disease characteristics (BMI, prior treatment, disease duration, and maintenance of clinical response at week 52). Improvements in PASI were greater in patients taking risankizumab than those taking secukinumab, regardless of weight or BMI. Results from logistic regression analysis showed treatment type had a significant impact on PASI 90 (risankizumab versus secukinumab, p < 0.0001).

Conclusion: Risankizumab showed consistently greater efficacy compared with secukinumab across different patient subgroups, and this was maintained through 52 weeks.

Trial registration: ClinicalTrials.gov identifier; NCT03478787.

Keywords: Biologics; Prior psoriasis treatment; Psoriasis; Risankizumab; Secukinumab; Subgroup analysis; Weight.

© 2022. The Author(s).

Figures

Fig. 1

Proportion of patients who achieved PASI 90 at week 52 by baseline demographics and disease characteristic subgroups (intent-to-treat population). BMI body mass index, PASI Psoriasis Area and Severity Index; PASI 90 ≥ 90% improvement in PASI, sPGA static Physician’s Global Assessment, 95% CI 95% confidence interval. aDuration of plaque psoriasis was not prespecified in the statistical analysis plan

Fig. 2

Proportion of patients who achieved PASI 90 at week 52 by BMI categories, weight categories, and weight quartiles (NRI) (a), and with improvement in PASI 90 as LS mean percent change from baseline at week 52 (LOCF) (b). *p < 0.05, **p < 0.01,***p < 0.001 versus secukinumab. BMI body mass index, LS least squares, LOCF last observation carried forward, NRI nonresponder imputation, PASI 90 ≥ 90% improvement in Psoriasis Area and Severity Index, 95% CI 95% confidence interval

Fig. 3

Proportion of patients who achieved PASI 90 at week 52 by prior treatment history (NRI) (a), type of treatment (b), and prior biologic treatment failure (c). IL interleukin, NRI nonresponder imputation, PASI 90 ≥ 90% improvement in Psoriasis Area and Severity Index, TNF tumor necrosis factor

Fig. 4

Clinical response maintenance at week 52 for patients who achieved PASI 90 at week 16 and maintained their clinical response at week 52 (NRI). NRI nonresponder imputation, PASI 90/100 ≥ 90%/100% improvement in Psoriasis Area and Severity Index, sPGA 0/1 static Physician’s Global Assessment of clear (0) or almost clear (1)