Risankizumab: Daily Practice Experience of High Need Patients

Abstract

Psoriasis is a chronic inflammatory disease which affects 29.5 million people worldwide and it can negatively impact quality of life, especially when it affects a special localization, such as nails, face, palms and soles, or intertriginous regions. Risankizumab is a humanized monoclonal antibody which targets the p19 subunit of interleukin-23 and it is currently licensed also as systemic therapy for moderate to severe plaque psoriasis. Here, we present eight cases of patients with moderate to severe psoriasis treated with risankizumab with a significant efficacy in the remission of the disease. Our cases represent a real-world clinical setting and provide a valuable adjunct to results obtained in the selected patients usually included in controlled clinical trials. In our cases, risankizumab rapidly improved clinical manifestations and relieved symptoms in patients with moderate to severe psoriasis, regardless of the presence of comorbidities or the location of the plaques in special sites, and without any safety concerns.

Effectiveness and Safety of Biological Therapies in Very Severe Plaque Psoriasis: A Real-Life Retrospective Study

“…The impact on patients' functional, psychological, and social outcomes is highly influenced by the body area where the disease occurs, especially when plaques involve sensitive areas like the face, palms, soles, nails, skin folds (inverse psoriasis), and genital region (seen in about one-third of patients). When the palms and soles are affected, thick, scaly, and painful plaques limit hand and foot function; nail involvement may lead to pitting, onycholysis, and nail dystrophy, leading to functional and esthetic damage [3,9,10].…”

“…Extensive real-world evidence indicates that higher psoriasis severity is linked to lower HRQoL and increased impairments in work productivity [9,10]. This is also explained by the higher prevalence of comorbidities compared to the general population; severe psoriasis is associated with a significant increased risk of myocardial infarction, coronary artery disease, stroke, and cardiovascular mortality, as well as metabolic syndrome, type 2 diabetes mellitus, inflammatory bowel diseases, depression, anxiety, and suicidal ideation [2][3][4][5][6][7].…”

“…Since clinical improvement aligns with a notable enhancement in quality of life, effective treatment is essential for patients with very severe psoriasis who are either not controlled by, intolerant to, or have contraindications to currently available systemic therapies [9]. In the last few years, evidence regarding the effectiveness of different biological drugs for psoriasis in a real-life setting has increased, whereas analyses of treatment survival are still limited to registry studies, multicenter studies, or small single-center case series [2,4,21].…”

“…The PASI generates a numerical score ranging from 0 (no psoriasis) to 72; a score below 10 defines psoriasis as mild, 10 to 15 as moderate, and above 15 as severe [4,8]. With itching, pain, and scaling as its key symptoms, psoriasis can have an important impact on patient's health-related quality of life (HRQoL) and work productivity, with growing real-world evidence showing an association of higher impairments with greater disease severity [9,10]. Conversely, reaching lower PASI values has been shown to correlate with better quality of life and work productivity [11].…”