POS1032 RISANKIZUMAB FOR ACTIVE PSORIATIC ARTHRITIS: INTEGRATED SUBGROUP ANALYSIS FROM 2 DOUBLE-BLIND, PLACEBO-CONTROLLED, PHASE 3 STUDIES (KEEPsAKE 1 AND KEEPsAKE 2)

Background

Risankizumab (RZB), a monoclonal antibody that specifically inhibits interleukin 23, is being investigated as a treatment for adults with psoriatic arthritis (PsA).

Objectives

We report the proportion of patients with active PsA treated with RZB vs placebo who achieved ≥20% improvement in American College of Rheumatology criteria (ACR20) by baseline demographics and by concomitant or prior medication use subgroups.

Methods

KEEPsAKE 1 (NCT03675308) and KEEPsAKE 2 (NCT03671148) are ongoing, multicenter, randomized, double-blind, placebo-controlled, phase 3 studies. Patients with active PsA with an inadequate response or intolerance to conventional synthetic disease-modifying, anti-rheumatic drug (csDMARD; KEEPsAKE 1 and 2) and/or biologic therapy (KEEPsAKE 2) received RZB 150 mg or placebo (1:1). The primary endpoint was the proportion of patients achieving ≥20% improvement in ACR criteria (ACR20) at week 24.

Results

In KEEPsAKE 1 (RZB, n=483; placebo, n=481) and KEEPsAKE 2 (RZB, n=224; placebo, n=219), baseline demographics and characteristics were generally balanced between treatment groups. In this integrated analysis, a greater proportion of patients receiving RZB vs placebo achieved ACR20 at week 24, regardless of age (<65 years, ≥65 years, ≥65 to <75 years, ≥75 years), sex, body mass index (<25 kg/m2, ≥25 to <30 kg/m2, ≥30 kg/m2), race (White, non-White), PsA duration (≤5 years, >5 to ≤10 years, >10 years), baseline hs-CRP (<3 mg/L, ≥3 mg/L), concomitant csDMARD at baseline (any csDMARD, any methotrexate, none), or prior biologics use (yes, no). The proportion of RZB-treated patients who achieved ACR20 was generally similar across most assessed demographic or prior treatment subgroups. No new safety concerns were observed with RZB.

Conclusion

RZB demonstrates efficacy vs placebo for active PsA as shown by greater proportions of patients achieving ACR20 at week 24, regardless of baseline demographics, concomitant csDMARD use at baseline, or prior biologic use.

Acknowledgements

AbbVie Inc. participated in the study design; study research; collection, analysis, and interpretation of data; funded the research for this study. Medical writing assistance, funded by AbbVie, was provided by Alicia Salinero, PhD, of JB Ashtin.

Disclosure of Interests

Joseph F. Merola Consultant of: Amgen, Bristol-Myers Squibb, AbbVie, Dermavant, Eli Lilly, Novartis, Janssen, UCB, Sanofi, Regeneron, Sun Pharma, Biogen, Pfizer and Leo Pharma, Kristina Callis-Duffin Consultant of: Amgen/Celgene, AbbVie, Boehringer-Ingelheim, Bristol-Myers Squibb, CorEvitas, Janssen, Lilly, Novartis, and Pfizer, Grant/research support from: Amgen/Celgene, AbbVie, Boehringer-Ingelheim, CorEvitas, Lilly, Janssen, Novartis, Pfizer, Byron Padilla Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Zhenyi Xue Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Huzefa Photowala Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Blair Kaplan Shareholder of: AbbVie Inc., Employee of: AbbVie Inc., Iain McInnes Consultant of: AbbVie, AstraZeneca, Boehringer Ingelheim, Bristol Myers, Celgene, Janssen, Leo, Lilly, Novartis, Pfizer, and UCB, Grant/research support from: AbbVie, AstraZeneca, Boehringer Ingelheim, Bristol Myers, Celgene, Janssen, Leo, Lilly, Novartis, Pfizer, and UCB

Efficacy of risankizumab in patients with moderate-to-severe plaque psoriasis by baseline demographics, disease characteristics and prior biologic therapy: an integrated analysis of the phase III UltIMMa-1 and UltIMMa-2 studies

BACKGROUND

Risankizumab is a humanized IgG monoclonal antibody that selectively inhibits interleukin-23 through binding the p19 subunit. In Phase 3 trials, risankizumab demonstrated superior efficacy compared with adalimumab and ustekinumab in patients with moderate-to-severe plaque psoriasis. Here, we evaluated the impact of baseline characteristics on efficacy of risankizumab compared with ustekinumab in patients with moderate-to-severe plaque psoriasis.

METHODS

This analysis included all patients initially randomized to risankizumab or ustekinumab from the replicate, double-blinded, randomized, placebo-controlled phase 3 trials, UltIMMa-1 (NCT02684370) and UltIMMa-2 (NCT02684357). Patients received either risankizumab (150 mg) or ustekinumab (weight-based; 45 or 90 mg per label) at weeks 0, 4, 16, 28 and 40. Efficacy was assessed as the proportion of patients achieving ≥90% improvement in Psoriasis Area and Severity Index (PASI 90) at weeks 16 and 52 by baseline patient demographics, disease characteristics and prior biologic exposure. Mean per cent improvement in PASI was calculated by body weight and body mass index at week 52. Missing efficacy data were imputed as non-responders for categorical variables and last observation carried forward for continuous variables. Logistic regression analyses assessed for interactions between treatment and five independent variables (age, sex, weight, baseline PASI score and presence of psoriatic arthritis) at both weeks 16 and 52.

RESULTS

Baseline patient demographics, disease characteristics and prior biologic exposure were similar between patients randomized to risankizumab (n = 598) and ustekinumab (n = 199). At weeks 16 and 52, risankizumab demonstrated superior efficacy compared with ustekinumab across these patient characteristics (P < 0.01). Logistic regression analyses demonstrated that risankizumab was superior to ustekinumab at weeks 16 and 52 in all models tested (P < 0.0001 for all).

CONCLUSIONS

Risankizumab demonstrated consistent and superior efficacy compared with ustekinumab regardless of patient demographics, disease characteristics or prior biologic exposure.