Meta-Analyses of Clinical Efficacy of Risankizumab and Adalimumab in Chronic Plaque Psoriasis: Supporting Evidence of Risankizumab Superiority

Abstract

Risankizumab, an anti-interleukin-23 monoclonal antibody, achieved significantly (P < 0.001) greater Psoriasis Area and Severity Index (PASI) and static Physician Global Assessment (sPGA) clear or almost clear (0/1) responses than adalimumab in a phase III trial in patients with moderate-to-severe psoriasis. Meta-analyses of the PASI 50, PASI 75, PASI 90, PASI 100, and sPGA0/1 responses after 16 weeks of treatment from eight (three for risankizumab and five for adalimumab) randomized, placebo-controlled trials were conducted to estimate the efficacy difference between risankizumab and adalimumab. For PASI 75, PASI 90, PASI 100, and sPGA0/1 responses, the estimated effect differences (95% confidence interval) between risankizumab and adalimumab were 15.2% (10.1%, 20.4%), 23.7% (15.7%, 31.2%), 20.8% (13.0%, 28.7%), and 20.1% (13.7%, 26.1%), respectively. These results were consistent with the observed efficacy difference from the head-to-head phase III trial, which was not included in the meta-analyses, providing independent, confirmatory evidence of the superior efficacy of risankizumab compared with adalimumab for treatment of moderate-to-severe psoriasis.

Figure 1

Observed Psoriasis Area and Severity Index (PASI) 50, PASI 75, PASI 90, PASI 100, and static Physician Global Assessment (sPGA) 0/1 responses after 16 weeks of treatment with adalimumab or risankizumab in the trials included in the analysis data set. Symbol size is proportional to sample size. *80 mg SC (subcutaneous) at week 0 followed by 40 mg q2w (every two weeks) starting week 1. **150 mg at week 0, week 4, and every 12 weeks thereafter.

Figure 2

Observed and meta‐analyses estimated absolute (a) PASI and (b) sPGA responses following treatment with adalimumab, risankizumab, or placebo. Circles: a observed PASI 50 (black), PASI 75 (purple), PASI 90 (red), and PASI 100 (orange) responses or b sPGA 0/1 responses. Horizontal error bars: 95% confidence intervals of a observed PASI or b sPGA 0/1 responses. Vertical pins: meta‐analyses estimated a PASI or b sPGA 0/1 responses. ADA, adalimumab; PASI, Psoriasis Area and Severity Index; PLC, placebo; RZB, risankizumab; sPGA, static Physician Global Assessment.