Risankizumab Demonstrates Superior Efficacy in Treating Plaque Psoriasis as Compared to Apremilast in Phase 4 Study

In a recent study published in the British Journal of Dermatology, it was found that for patients with moderate psoriasis, treatment with risankizumab demonstrated superior efficacy compared to apremilast.

plaque psoriasis

AbbVie’s phase 4 head-to-head study, IMMpulse, evaluated both risankizumab, an interleukin-23 inhibitor, and apremilast, which inhibits phosphodiesterase 4.

The study was a multicenter, randomized, open-label, efficacy assessor-blinded study which took place over the course of 52 weeks. It included a total of 352 patients over 18 years with a diagnosis of moderate chronic plaque psoriasis who were candidates for systemic therapy. Of these, 118 received subcutaneous risankizumab at a dosage of 150 mg at week zero and week four. A total of 235 received oral apremilast at a dosage of 30 mg twice a day.

At week 16, if those patients receiving apremilast had not achieved a Psoriasis Area and Severity Index (PASI) 75 response, they were re-randomized to receive either risankizumab or apremilast.

At week 16, results showed that 55.9% of patients treated with risankizumab achieved the co-primary endpoint of PASI 90 compared to only 5.1% of those treated with apremilast.

As for the co-primary endpoint of static Physician’s Global Assessment (sPGA) 0/1, this was achieved by 75.4% of those treated with risankizumab compared to 18.4% of apremilast-treated patients.

A total of 83 apremilast-treated patients who failed to reach PASI 75 by week 16 were switched to risankizumab and 78 continued with apremilast. By week 52, 72.3% of these patients who had switched to risankizumab had achieved PASI 90 compared to only 2.6% who continued on apremilast.

Of those patients who received continuous treatment, results at 52 weeks demonstrated that 73.7% of those treated with risankizumab achieved PASI 90, and 63.6% achieved PASI 100. For those treated with apremilast, 4.5% achieved PASI 90 by week 52 and 2.7% PASI 100.

Patients were also provided with a Treatment Satisfaction Questionnaire for Medication. At week 16, those treated with risankizumab reported higher overall scores than those treated with apremilast:

Satisfaction with Effectiveness
Satisfaction with Convenience
Global Satisfaction

The most frequent adverse events reported in risankizumab were COVID-19 and nasopharyngitis. For those receiving apremilast, diarrhea, nausea, and headaches were most common.

The study concluded that “risankizumab treatment can significantly improve clinical outcomes in systemic-eligible patients with moderate psoriasis compared to apremilast.”


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