Strober Bruce, Patel Manish, Kaldas Mark I, St John Greg, Photowala Huzefa, Sima Adam P, Eckmann Thomas, Beeghly Alicia, Armstrong April
Department of Dermatology, Yale University School of Medicine, New Haven, CT, USA.
Central Connecticut Dermatology Research, Cromwell, CT, USA.
Dermatol Ther (Heidelb). 2025 Jul 2. doi: 10.1007/s13555-025-01474-3.
The International Psoriasis Council (IPC) reclassified patients eligible for systemic therapy to include those with body surface area (BSA) > 10%, psoriasis lesions in high-impact areas, or failure of topical therapy. Risankizumab is an interleukin-23 inhibitor approved for the treatment of moderate-to-severe plaque psoriasis. This retrospective study evaluated the real-world effectiveness of risankizumab in patients with BSA 3-10% and patients meeting IPC systemic therapy criteria, addressing existing gaps in knowledge regarding its effectiveness in these patient groups.
Biologic-naïve adults with moderate-to-severe plaque psoriasis who initiated risankizumab between April 2019 and August 2023 and were treated for 12 (± 3) months were identified from the CorEvitas Psoriasis Registry and stratified by baseline BSA. At 12 months, skin clearance was assessed by achievement of Psoriasis Area Severity Index (PASI) 90, PASI 100, and National Psoriasis Foundation (NPF) treat-to-target goals. Patient-reported outcomes (PROs) included achievement of Dermatology Life Quality Index (DLQI) 0/1, improvements in psoriasis symptoms, and work and activity impairment.
Of 272 patients analyzed, 123 had BSA 3-10% (78 had any high-impact area involvement and 105 had prior topical therapy experience) and 149 patients had BSA > 10%. Among those with BSA 3-10%, 77.9% achieved PASI 90 and 67.2% achieved PASI 100. NPF acceptable and target responses were met by 95.3% and 87.9%, respectively. Regarding PROs, 68.1% of patients with moderate skin involvement (BSA 3-10%) attained a DLQI score of 0/1. Significant improvements from baseline in psoriasis symptoms and reductions in work and life impairments were also reported (P < .001). Comparable positive outcomes were observed across all IPC systemic therapy eligible patient subgroups.
In patients with BSA 3-10% and those systemic-eligible per IPC classification, continuous treatment with risankizumab for 12 months resulted in high levels of skin clearance and improvements in PROs.
国际银屑病理事会（IPC）对符合全身治疗条件的患者进行了重新分类，包括那些体表面积（BSA）>10%、高影响区域有银屑病皮损或局部治疗失败的患者。瑞莎珠单抗是一种获批用于治疗中度至重度斑块状银屑病的白细胞介素-23抑制剂。这项回顾性研究评估了瑞莎珠单抗在BSA为3%-10%的患者以及符合IPC全身治疗标准的患者中的实际疗效，填补了关于其在这些患者群体中疗效的现有知识空白。
从CorEvitas银屑病登记处识别出2019年4月至2023年8月期间开始使用瑞莎珠单抗并接受了12（±3）个月治疗的中度至重度斑块状银屑病初治成人患者，并根据基线BSA进行分层。在12个月时，通过达到银屑病面积和严重程度指数（PASI）90、PASI 100以及国家银屑病基金会（NPF）治疗达标目标来评估皮肤清除情况。患者报告的结局（PROs）包括达到皮肤病生活质量指数（DLQI）0/1、银屑病症状改善以及工作和活动受限情况。
在分析的272例患者中，123例患者的BSA为3%-10%（78例有任何高影响区域受累，105例有局部治疗经验），149例患者的BSA>10%。在BSA为3%-10%的患者中，77.9%达到了PASI 90，67.2%达到了PASI 100。NPF可接受和目标反应分别达到了95.3%和87.9%。关于PROs，68.1%的中度皮肤受累（BSA为3%-10%）患者的DLQI评分为0/1。银屑病症状较基线也有显著改善，工作和生活受限情况减少（P<0.001）。在所有符合IPC全身治疗条件的患者亚组中均观察到了类似的积极结果。
在BSA为3%-10%的患者以及符合IPC分类全身治疗条件的患者中，连续使用瑞莎珠单抗治疗12个月可实现高水平的皮肤清除并改善PROs。
