Efficacy of Risankizumab in Patients with Suboptimal Response or Failure to Ustekinumab: A Multicenter Retrospective Study in Spain

Abstract

Background. Current psoriasis treatment goals emphasize achieving complete or near-complete skin clearance while preserving the quality of life, necessitating treatment modification for a suboptimal or inadequate response. Despite risankizumab’s demonstrated efficacy, evidence remains limited for patients switching from ustekinumab, particularly those with suboptimal or inadequate response. Objective. This study assesses risankizumab’s real-world effectiveness in patients with suboptimal response (PASI 2-3), inadequate response (PASI 3–5), or failure (PASI >5) to ustekinumab, based on a multicenter retrospective cohort in Spain. Method. A multicenter retrospective study across 24 Spanish hospitals included 102 patients previously treated with ustekinumab and switched to risankizumab. Results. Out of 102 patients, 78 experienced ustekinumab treatment failure (PASI >5), while 24 had an inadequate response (PASI 3–5), including 6 with a suboptimal response (PASI 2-3). Remarkably, after one year of treatment with risankizumab, all patients demonstrated improvement, achieving near-complete or complete skin clearance (PASI 0-1). Conclusion. Risankizumab displayed effectiveness in patients with suboptimal/inadequate response or treatment failure to ustekinumab, aligning with the current treatment goals of complete or near-complete skin clearance. These real-world results corroborate clinical trial data, emphasizing risankizumab’s potential as a powerful therapeutic alternative for this patient population. Further prospective studies are essential to validate these findings.