Efficacy and safety of risankizumab versus methotrexate in patients with moderate-to-severe plaque psoriasis: results from IMMbrace, a randomized, double-blind, phase 3 study with an open-label extension period in Brazil

Abstract: Background: Psoriasis, a chronic, inflammatory skin disease, requires long-term therapy. Risankizumab is a humanized immunoglobulin G1 monoclonal antibody that specifically inhibits interleukin 23 by binding to its p19 subunit. Objective: The authors assessed the efficacy and safety of r...

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Main Authors: Tania F. Cestari, Cacilda da Silva Souza, Luna Azulay-Abulafia, Ricardo Romiti, André V.E. Carvalho, Caio César Silva de Castro, Sílvio Alencar Marques, João Roberto Antonio, Lincoln Fabrício, Ahmed M. Soliman, Tianshuang Wu, Ranjeeta Sinvhal, Vassilis Stakias, Alexandra P. Song, Jasmina Kalabic, Naomi Martin, Luiza Keiko Matsuka Oyafuso
Format: Article
Language:English
Published: Sociedade Brasileira de Dermatologia 2025-04-01
Series:Anais Brasileiros de Dermatologia
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962025000200308&lng=en&tlng=en
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author Tania F. Cestari
Cacilda da Silva Souza
Luna Azulay-Abulafia
Ricardo Romiti
André V.E. Carvalho
Caio César Silva de Castro
Sílvio Alencar Marques
João Roberto Antonio
Lincoln Fabrício
Ahmed M. Soliman
Tianshuang Wu
Ranjeeta Sinvhal
Vassilis Stakias
Alexandra P. Song
Jasmina Kalabic
Naomi Martin
Luiza Keiko Matsuka Oyafuso
author_facet Tania F. Cestari
Cacilda da Silva Souza
Luna Azulay-Abulafia
Ricardo Romiti
André V.E. Carvalho
Caio César Silva de Castro
Sílvio Alencar Marques
João Roberto Antonio
Lincoln Fabrício
Ahmed M. Soliman
Tianshuang Wu
Ranjeeta Sinvhal
Vassilis Stakias
Alexandra P. Song
Jasmina Kalabic
Naomi Martin
Luiza Keiko Matsuka Oyafuso
author_sort Tania F. Cestari
collection DOAJ
description Abstract: Background: Psoriasis, a chronic, inflammatory skin disease, requires long-term therapy. Risankizumab is a humanized immunoglobulin G1 monoclonal antibody that specifically inhibits interleukin 23 by binding to its p19 subunit. Objective: The authors assessed the efficacy and safety of risankizumab compared with methotrexate in adults with moderate-to-severe plaque psoriasis. Methods: IMMbrace was a phase 3, multicenter, randomized, double-blind, double-dummy, active-controlled study. Patients received subcutaneous risankizumab 150 mg at weeks 0, 4, and 16 plus oral placebo weekly, or oral methotrexate 5 mg weekly (with dose escalation up to 25 mg based on response and tolerability) plus subcutaneous placebo at weeks 0, 4, and 16. Primary efficacy endpoints were the proportions of patients who achieved ≥ 90% improvement in Psoriasis Area and Severity Index (PASI90) and static Physician’s Global Assessment of clear/almost clear (sPGA 0/1) at week 28. Safety was also assessed. Results: Among 98 patients randomized (risankizumab, n = 50; methotrexate, n = 48), 95 completed the double-blind period. At week 28, significantly higher proportions of patients treated with risankizumab versus methotrexate achieved PASI90 (84.0% vs. 35.4%; p < 0.001); sPGA 0/1 was achieved by 90.0% and 64.6% of patients in the risankizumab and methotrexate groups(p ≤ 0.001). Risankizumab efficacy was maintained throughout week 112. Adverse event rates were similar in the two groups. Study limitations: The sample size was small due to the difficulty of recruiting patients without methotrexate use. Conclusions: Risankizumab demonstrated superior efficacy over methotrexate at week 28; efficacy was maintained, and no new safety findings were observed through week 112.
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spelling doaj-art-2c070b4d375c4b338a05b8fa85b482382025-08-20T03:52:32ZengSociedade Brasileira de DermatologiaAnais Brasileiros de Dermatologia0365-05962025-04-01100210.1016/j.abd.2024.08.002Efficacy and safety of risankizumab versus methotrexate in patients with moderate-to-severe plaque psoriasis: results from IMMbrace, a randomized, double-blind, phase 3 study with an open-label extension period in BrazilTania F. Cestarihttps://orcid.org/0000-0003-3001-0202Cacilda da Silva Souzahttps://orcid.org/0000-0002-8157-7658Luna Azulay-Abulafiahttps://orcid.org/0000-0002-4698-2009Ricardo Romitihttps://orcid.org/0000-0003-0165-3831André V.E. Carvalhohttps://orcid.org/0000-0002-0407-538XCaio César Silva de Castrohttps://orcid.org/0000-0001-9767-5765Sílvio Alencar Marqueshttps://orcid.org/0000-0002-5512-4700João Roberto Antoniohttps://orcid.org/0000-0002-0268-5934Lincoln Fabríciohttps://orcid.org/0000-0001-9191-1085Ahmed M. Solimanhttps://orcid.org/0009-0008-8632-1396Tianshuang Wuhttps://orcid.org/0009-0007-4205-9579Ranjeeta Sinvhalhttps://orcid.org/0009-0003-1950-9181Vassilis Stakiashttps://orcid.org/0009-0006-2628-0399Alexandra P. Songhttps://orcid.org/0000-0002-8344-6651Jasmina Kalabichttps://orcid.org/0009-0007-4698-1042Naomi Martinhttps://orcid.org/0009-0006-9169-8791Luiza Keiko Matsuka Oyafusohttps://orcid.org/0000-0003-3982-3322Abstract: Background: Psoriasis, a chronic, inflammatory skin disease, requires long-term therapy. Risankizumab is a humanized immunoglobulin G1 monoclonal antibody that specifically inhibits interleukin 23 by binding to its p19 subunit. Objective: The authors assessed the efficacy and safety of risankizumab compared with methotrexate in adults with moderate-to-severe plaque psoriasis. Methods: IMMbrace was a phase 3, multicenter, randomized, double-blind, double-dummy, active-controlled study. Patients received subcutaneous risankizumab 150 mg at weeks 0, 4, and 16 plus oral placebo weekly, or oral methotrexate 5 mg weekly (with dose escalation up to 25 mg based on response and tolerability) plus subcutaneous placebo at weeks 0, 4, and 16. Primary efficacy endpoints were the proportions of patients who achieved ≥ 90% improvement in Psoriasis Area and Severity Index (PASI90) and static Physician’s Global Assessment of clear/almost clear (sPGA 0/1) at week 28. Safety was also assessed. Results: Among 98 patients randomized (risankizumab, n = 50; methotrexate, n = 48), 95 completed the double-blind period. At week 28, significantly higher proportions of patients treated with risankizumab versus methotrexate achieved PASI90 (84.0% vs. 35.4%; p < 0.001); sPGA 0/1 was achieved by 90.0% and 64.6% of patients in the risankizumab and methotrexate groups(p ≤ 0.001). Risankizumab efficacy was maintained throughout week 112. Adverse event rates were similar in the two groups. Study limitations: The sample size was small due to the difficulty of recruiting patients without methotrexate use. Conclusions: Risankizumab demonstrated superior efficacy over methotrexate at week 28; efficacy was maintained, and no new safety findings were observed through week 112.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962025000200308&lng=en&tlng=enMethotrexatePsoriasisRisankizumab
spellingShingle Tania F. Cestari
Cacilda da Silva Souza
Luna Azulay-Abulafia
Ricardo Romiti
André V.E. Carvalho
Caio César Silva de Castro
Sílvio Alencar Marques
João Roberto Antonio
Lincoln Fabrício
Ahmed M. Soliman
Tianshuang Wu
Ranjeeta Sinvhal
Vassilis Stakias
Alexandra P. Song
Jasmina Kalabic
Naomi Martin
Luiza Keiko Matsuka Oyafuso
Efficacy and safety of risankizumab versus methotrexate in patients with moderate-to-severe plaque psoriasis: results from IMMbrace, a randomized, double-blind, phase 3 study with an open-label extension period in Brazil
Anais Brasileiros de Dermatologia
Methotrexate
Psoriasis
Risankizumab
title Efficacy and safety of risankizumab versus methotrexate in patients with moderate-to-severe plaque psoriasis: results from IMMbrace, a randomized, double-blind, phase 3 study with an open-label extension period in Brazil
title_full Efficacy and safety of risankizumab versus methotrexate in patients with moderate-to-severe plaque psoriasis: results from IMMbrace, a randomized, double-blind, phase 3 study with an open-label extension period in Brazil
title_fullStr Efficacy and safety of risankizumab versus methotrexate in patients with moderate-to-severe plaque psoriasis: results from IMMbrace, a randomized, double-blind, phase 3 study with an open-label extension period in Brazil
title_full_unstemmed Efficacy and safety of risankizumab versus methotrexate in patients with moderate-to-severe plaque psoriasis: results from IMMbrace, a randomized, double-blind, phase 3 study with an open-label extension period in Brazil
title_short Efficacy and safety of risankizumab versus methotrexate in patients with moderate-to-severe plaque psoriasis: results from IMMbrace, a randomized, double-blind, phase 3 study with an open-label extension period in Brazil
title_sort efficacy and safety of risankizumab versus methotrexate in patients with moderate to severe plaque psoriasis results from immbrace a randomized double blind phase 3 study with an open label extension period in brazil
topic Methotrexate
Psoriasis
Risankizumab
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962025000200308&lng=en&tlng=en
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