Results of the AIMM study show that switching patients that show suboptimal response on an IL-17 blocker to an IL-23 blocker is a successful treatment strategy. All endpoints improved up to week 52 and the agent was well tolerated.
In the open, single-arm study, all patients were required to be on an IL-17 blocker (secucinumab or ixekizumab) for at least 6 months and show suboptimal response (defined as static Physician’s Global Assessment [sPGA] 2/3 and BSA affected 3% to < 10%) on treatment. Later, they were treated with 150 mg risankizumab at weeks 0, 4, and every 12 weeks through week 40 without a washout period.
Richard Warren, BSc, MBChB, MRCP, PhD, explained the significance of this data at the 2023 American Academy of Dermatology annual meeting1. “This data is important, because it is unknown whether patients are doing well after switching biologics,” he said. “The current study specifically addresses this question. That reflects what we do in clinical practice”.
At week 16 after the switch, the primary study endpoint was the percentage of participants achieving PGA 0/1 (clear or almost clear skin). In addition, at week 16 and 52, the percentage of patients achieving PGA 0, a QOL no longer impaired by the disease (corresponding to a Dermatology Life Quality Index of 0), and Psoriasis Symptom Scale (PSS) scores were assessed as secondary endpoints. “The mean disease duration was 20.8 years,” Dr. Warren said. “This is a tough-to-treat population.”
At week 16, 52% of participants treated with risankizumab achieved the primary endpoint (sPGA 0/1). Furthermore, participants demonstrated a numerical improvement in all endpoints between week 16 and week 52. “Between weeks 16 and 52, there is an accrual of each outcome,” Dr. Warren noted, adding that. 63% of participants achieved sPGA of 0/1 and almost half of the participants (46%) achieved an unimpaired QOL. A total of 27.4% of participants even achieved a 0 score on PSS at this time, a “hard-to-meet endpoint,” Dr. Warren said. No new safety signals were observed in this analysis.
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