Skyrizi and erythrodermic psoriasis

[Fred]

This study evaluated treatment response to Skyrizi (risankizumab) and identify potential predictors influencing the treatment response in patients with erythrodermic psoriasis.

Quote:

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Erythrodermic psoriasis (EP) is a severe and challenging variant of psoriasis that often shows poor drug survival. While risankizumab, an IL-23 inhibitor, has demonstrated efficacy in patients with moderate-to-severe plaque psoriasis, its effectiveness in patients with a history of EP is less explored.

This study aimed to evaluate treatment response to risankizumab and identify potential predictors influencing the treatment response. In this single-center, longitudinal retrospective study, we included 56 patients treated with risankizumab between August 1, 2016, and June 1, 2023, of whom 22 had a history of EP.

Treatment response was assessed using the Psoriasis Area and Severity Index (PASI), and the impact of patient characteristics, including prior biologic exposure and HLA-Cw genotypes, on treatment response was analysed using the Mann–Whitney U test.

Throughout the 100-week follow-up, patients with a history of EP exhibited a poorer treatment response compared to those without such a history. Among patients with a history of EP, those with prior exposure to guselkumab and those treated with more than five biologics demonstrated a decreased response to risankizumab. Additionally, there was a non-significant trend indicating that HLA-Cw1–negative patients responded better to risankizumab.

This case series indicated that risankizumab might be an effective and sustainable treatment option for most patients with a history of EP. However, prior exposure to multiple biologics, particularly those with a similar mode of action targeting IL-23, may reduce its effectiveness. The potential association between HLA-Cw1 genotype and treatment response warrants further investigation.

Source: onlinelibrary.wiley.com

*Funding: The authors received no specific funding

Skyrizi (risankizumab)

Erythrodermic Psoriasis

[Turnedlight]

I’ve been trying to find out for ages, and here it is in print - ‘prior exposure to multiple biologics’ may reduce effectiveness. Just great.

[Fred]

I’ve been trying to find out for ages, and here it is in print - ‘prior exposure to multiple biologics’ may reduce effectiveness. Just great.

Yes not good news, I haven't had erythrodermic but I'm on my 9th bio (I think) and the one I'm on now has been the best.