Risankizumab versus Ustekinumab for Moderate-to-Severe Plaque Psoriasis

In this Phase II study in 166 patients with moderate-to-severe plaque psoriasis, more patients randomised to treatment with risankizumab than ustekinumab achieved a ≥90% reduction in Psoriasis Area and Severity Index score at week 12 (77% v 40%; p<0.001).

Risankizumab is a humanised IgG1 monoclonal antibody that binds to and neutralises the p19 subunit of interleukin-23, whereas ustekinumab inhibits both interleukin-12 and interleukin-23. Risankizumab is currently in Phase III development for psoriasis in the UK and EU.

NICE currently recommends ustekinumab, etanercept, adalilumab or secukinumab as a treatment option for adults with plaque psoriasis when the disease is severe (total PASI score of 10 or more and a DLQI score of more than 10) and the psoriasis has not responded to standard systemic therapies including ciclosporin, methotrexate and PUVA, or the person is intolerant of or has a contraindication to these treatments. Infliximab is recommended as an option for those with very severe disease (total PASI of 20 or more and a DLQI of more than 18). For further information please see the NICE pathway on psoriasis, available at the link below.