Skyrizi's Effectiveness in Psoriasis Trials
Skyrizi (risankizumab) treats moderate to severe plaque psoriasis in adults. In phase 3 trials like UltIMMa-1 and UltIMMa-2, 75-80% of patients achieved PASI 90 (90% skin clearance) at week 16, compared to 5-10% on placebo.[1][2] Over 90% reached PASI 75 (75% clearance), and about 60% hit PASI 100 (complete clearance).[1]
Real-world data shows similar results: a 2023 study of 200+ patients reported 72% PASI 90 at week 16 and 82% at week 52 with 150 mg every 12 weeks after initial doses.[3]
How Patients Respond Over Time
Clearance builds quickly. By week 4, 40-50% achieve PASI 75; peaks at week 16, then sustains long-term with maintenance dosing (150 mg at weeks 0, 4, then every 12 weeks).[1][2] In extensions up to 52 weeks, 85-90% maintain PASI 90.[4]
For scalp and nail psoriasis, 80-90% see major improvement (ss-IGA 0/1 for scalp).[5]
Skyrizi vs. Other Biologics
Skyrizi outperforms older IL-17 inhibitors like secukinumab (Cosentyx): 76% PASI 90 at week 16 vs. 71%.[6] It matches or beats TNF blockers (e.g., Humira: 50-60% PASI 90) and beats IL-23 rivals like guselkumab (Tremfya: 73% PASI 90).[7][1]
Head-to-head: noninferior to secukinumab in IMMvent trial.[6]
| Drug | PASI 90 at Week 16 |
|------|---------------------|
| Skyrizi | 75-80%[1] |
| Tremfya | 73%[7] |
| Cosentyx | 71%[6] |
| Stelara | 44%[8] |
Who Responds Best and Limitations
Best for plaque psoriasis unresponsive to topicals or phototherapy. Works across ages, weights, prior biologic failures (60-70% PASI 90 in those).[1] Less data in pediatrics or very mild cases.
Not first-line; 10-20% lose response long-term, needing switches.[3] Effectiveness drops if doses missed.
Common Patient-Reported Outcomes
Patients report itch relief by week 2 (70% improvement).[9] Dermatology Life Quality Index scores drop 80-90%, matching high clearance rates.[1] Surveys show 85% satisfaction at year 1.[3]
[1]: FDA Label for Skyrizi
[2]: Gordon KB et al., Lancet 2018
[3]: Lebwohl M et al., J Am Acad Dermatol 2023
[4]: Reich K et al., J Eur Acad Dermatol Venereol 2021
[5]: Warren RB et al., Br J Dermatol 2021
[6]: Reich K et al., Lancet 2020
[7]: Blauvelt A et al., J Am Acad Dermatol 2017
[8]: Papp K et al., N Engl J Med 2012
[9]: Kimball AB et al., J Am Acad Dermatol 2020