How Skyrizi Stacks Up Against Humira for Plaque Psoriasis
Skyrizi (risankizumab) and Humira (adalimumab) both treat moderate to severe plaque psoriasis, but Skyrizi shows higher skin clearance rates in head-to-head trials. In the phase 3 head-to-head study, 75% of Skyrizi patients achieved PASI 90 (90% improvement in Psoriasis Area and Severity Index) at week 16, compared to 48% on Humira. For PASI 100 (complete clearance), rates were 54% versus 12%.[1][2]
Skyrizi targets IL-23 specifically, while Humira blocks TNF-alpha, which may explain Skyrizi's edge in efficacy for skin clearance. Both reduce symptoms like plaques and scaling, but Skyrizi maintains responses longer with less frequent dosing.
Dosing Schedules and Convenience
Skyrizi requires two 150 mg subcutaneous injections at week 0, then every 12 weeks. Humira starts with injections every other week for life, often 40-80 mg doses. Patients report Skyrizi's quarterly schedule as less burdensome.[1][3]
Common Side Effects Patients Experience
Both carry infection risks due to immune suppression. Skyrizi's most reported issues include upper respiratory infections (14%), headache (5%), and fatigue (4%); serious infections occur in under 1%. Humira has higher rates of injection-site reactions (20%), infections (23%), and rash (6%), with added risks like reactivation of tuberculosis or heart failure. Skyrizi shows no increased malignancy risk in trials up to 52 weeks.[1][4]
| Aspect | Skyrizi | Humira |
|--------|---------|--------|
| PASI 90 at Week 16 | 75% | 48% |
| Dosing Frequency | Every 12 weeks | Every 2 weeks |
| Infection Rate | ~14% (mild) | ~23% |
| Injection Reactions | <5% | ~20% |
Long-Term Data and Durability
At week 52, 89% of Skyrizi patients kept PASI 90, versus 50% withdrawing from Humira arms in extensions. Skyrizi's IL-23 mechanism sustains remission better, with some patients staying clear beyond 2 years on maintenance.[1][2]
Cost and Insurance Coverage
Humira costs about $7,000 per month without insurance, while Skyrizi runs $5,000-$6,000 monthly, though copay cards drop both under $10 for eligible patients. Humira faces biosimilar competition since 2023, potentially lowering prices; Skyrizi's patents extend exclusivity to 2033.[5][6]
Who Might Switch from Humira to Skyrizi?
Patients failing Humira (about 50% by week 16) often respond to Skyrizi, with 72% achieving PASI 90 after switching. Dermatologists recommend Skyrizi first-line for better clearance and convenience, per guidelines.[2][7]
Sources
[1] NEJM: Head-to-Head Trial (IMMvent)
[2] Skyrizi Prescribing Info & Data
[3] Humira Prescribing Info
[4] Skyrizi FDA Label
[5] Drugs.com Pricing
[6] DrugPatentWatch: Skyrizi Patents
[7] AAD Psoriasis Guidelines