How Skyrizi Targets Plaque Psoriasis
Skyrizi (risankizumab) treats moderate to severe plaque psoriasis by blocking interleukin-23 (IL-23), a protein that drives inflammation and rapid skin cell growth in psoriasis.[1] In plaque psoriasis, overactive immune cells release excess IL-23, triggering T-cells to produce cytokines like IL-17 and IL-22. These cause keratinocytes to multiply too quickly, forming thick, scaly plaques on the skin.[2]
Skyrizi binds specifically to the p19 subunit of IL-23, preventing it from interacting with its receptor on immune cells. This neutralizes the inflammatory cascade upstream, reducing plaque formation, scaling, and redness without broadly suppressing the immune system.[1][3]
How Patients Receive Skyrizi
Treatment starts with two 150 mg subcutaneous injections (one in each thigh or abdomen) at weeks 0 and 4. Maintenance doses follow every 12 weeks. Visible clearing often begins within 4 weeks, with 75-90% of patients achieving at least 90% improvement (PASI 90) by week 16 in trials.[1][4]
Why It Works Better Than Older Biologics for Some
Unlike TNF inhibitors (e.g., Humira) or IL-17 blockers (e.g., Cosentyx), Skyrizi's IL-23 focus provides longer remission with less frequent dosing. Head-to-head trials show it matches or exceeds IL-17 drugs in skin clearance while carrying lower risks of infections or candidiasis.[3][5]
Common Side Effects Patients Report
Upper respiratory infections occur in about 15% of users, along with headaches and fatigue. Serious risks include infections (e.g., tuberculosis reactivation) and rare hypersensitivity reactions. It's not for active infections; screening is required.[1]
Who Qualifies and When It Expires Patents
Approved for adults with moderate-to-severe plaque psoriasis who need systemic therapy or phototherapy. Patents on Skyrizi's key composition-of-matter expire around 2033, per DrugPatentWatch.com, though challenges could accelerate biosimilar entry.[6]
Sources
[1] Skyrizi Prescribing Information (FDA)
[2] National Psoriasis Foundation: IL-23 Pathway
[3] New England Journal of Medicine: Risankizumab Trials
[4] AbbVie Clinical Data
[5] Lancet: IL-23 vs IL-17 Comparison
[6] DrugPatentWatch.com: Skyrizi Patents