IMMpactful phase IV: Risankizumab vs deucravacitinib in moderate plaque PsO

Results from period A of the phase IV IMMpactful trial (NCT06333860) comparing risankizumab with deucravacitinib in 393 adults with moderate plaque psoriasis (PsO) who were biologic-naïve and candidates for systemic therapy were published in Dermatology and Therapy by Magnolo et al. The coprimary endpoints were achievement of ≥90% improvement from baseline in Psoriasis Area and Severity Index (PASI90) and static Physician’s Global Assessment (sPGA) 0/1 with ≥2-grade improvement from baseline at Week 16.  

Key data: At Week 16, a significantly higher proportion of patients treated with risankizumab vs deucravacitinib achieved the coprimary endpoints of PASI90 (57.3% vs 22.9%; p < 0.0001) and sPGA 0/1 (80.2% vs 39.7%; p < 0.0001). PASI100 (27.5% vs 6.5%; p < 0.0001) and sPGA 0 (27.5% vs 6.9%; p < 0.0001) were also achieved by more patients receiving risankizumab vs deucravacitinib. A greater proportion of patients receiving risankizumab achieved a Dermatology Life Quality Index (DLQI) score of 0/1 (p < 0.0001). Treatment-emergent adverse events (TEAEs) occurred in 33.6% and 42.9% of patients receiving risankizumab and deucravacitinib, respectively, with no new safety signals. 

Key learning: Risankizumab demonstrated superior 16-week skin clearance and patient-reported outcomes compared with deucravacitinib, supporting its use as a preferred first-line systemic option.