For the treatment of moderate to severe plaque psoriasis, risankizumab had the highest long-term efficacy, according to study results presented at the American Academy of Dermatology’s Virtual Meeting Experience (AAD VMX) 2021, held online from April 23 to April 25, 2021.
Publication databases were searched through July 1 of 2020 for studies of short-term (10-16 weeks) and long-term (48-52 weeks) efficacy for the treatment of moderate to severe plaque psoriasis. A total of 71 studies comprising 18 treatments were included in the short-term analysis and 11 studies of 8 treatments in the long-term analysis.
In the short term, Psoriasis Area and Severity Index (PASI) of 75, 90, and 100 was achieved by more patients treated with 160 mg ixekizumab at baseline and 80 mg every other week (surface under the cumulative ranking curves [SUCRA], 0.951), 150 mg risankizumab at weeks 0 and 4 and every 12 weeks (SUCRA, 0.940), and 210 mg brodalumab for 3 weeks then every other week (SUCRA, 0.930). The poorest short-term efficacy was observed with dimethyl fumarate (SUCRA, 0.092).
Compared with placebo, the odds ratio (OR) of achieving a PASI of 100 was 757.82 (95% credible interval [CrI], 577.18-990.53) for ixekizumab, 740.37 (95% CrI, 571.56-969.06) for risankizumab, and 725.14 (95% CrI, 554.07-966.46) for brodalumab. Odds were increased for achieving at least a PASI of 75 for these 3 therapies compared with all others.
The most effective long-term therapy was 150 mg risankizumab at week 0 and 4 then every 12 weeks (SUCRA, 0.998) followed by 210 mg brodalumab weekly for 3 weeks then every 2 weeks (SUCRA, 0.786), and the least effective was 50 mg etanercept biweekly for 12 weeks then weekly (SUCRA, 0.001). Odds for achieving at least a PASI of 75 were increased in recipients of risankizumab compared with all other therapies.
This study was limited by the scarcity of long-term data for patients with plaque psoriasis and the potential between-study variation of patient characteristics.
These data indicated to the researchers that risankizumab was the most effective long-term treatment and ixekizumab, risankizumab, and brodalumab the most effective short-term therapies.
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
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Armstrong A W, Soliman A M, Puig L, Betts K A, Wang Y, Gao Y. Comparative Efficacy of Treatments for Moderate-to-Severe Plaque Psoriasis: An Updated Network Meta-Analysis (NMA). Presented at: AAD VMX 2021; April 23-25, 2021. Abstract/Poster 25030.