P100 Effectiveness of risankizumab in biologic-naive and biologic-experienced patients with psoriasis: real-world data from the BADBIR registry

Abstract Risankizumab is an anti-interleukin-23 monoclonal antibody approved to treat moderate-to-severe psoriasis in the UK. Risankizumab can be used in first-line (biologic-naive) or biologic-experienced patients who have not responded to or are unable to tolerate their current therapy. Data collected in BADBIR from 15 July 2019 to 30 July 2024 were used to assess patients’ responses to risankizumab using Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI) in biologic-naive and biologic-experienced cohorts. Data were analysed for patients who had a recorded baseline score at risankizumab initiation and at least one follow-up score within 2 years of initiation. At baseline, mean PASI scores were 13.1 (SD 8.72, n = 403) for the biologic-naive and 8.75 (SD 8.27, n = 679) for the biologic-experienced risankizumab cohorts. Mean PASI scores fell to 1.00 (SD 1.66, n = 126) in the biologic-naive cohort within 6 months and 1.41 (SD 3.52, n = 103) within 2 years. Mean PASI scores in the biologic-experienced cohort fell to 2.76 (SD 4.56, n = 279) within 6 months and 2.61 (SD 4.56, n = 188) within 2 years. Significantly more biologic-naive patients had achieved ≥ 90% and 100% improvement in Psoriasis Area and Severity Index (PASI 90 and PASI 100, respectively) than biologic-experienced patients within 2 years. In total, 74.6% of biologic-naive patients (n = 297/398) vs. 42.1% of biologic-experienced patients (n = 272/646) achieved PASI 90, P < 0.001; while 56.5% of biologic-naive patients (n = 225/398) vs. 30.8% of biologic-experienced patients (n = 199/646) achieved PASI 100, P < 0.001. At baseline, mean DLQI scores were 9.44 (SD 9.28, n = 419) for the biologic-naive and 8.71 (SD 8.02, n = 233) for the biologic-­experienced cohorts. The mean DLQI score reduction was greater in the biologic-naive cohort than in the biologic-­experienced cohort, decreasing to 2.63 (SD 5.19, n = 120) vs. 4.57 (SD 5.84, n = 78), respectively, within 6 months, P < 0.001. By 2 years, the mean DLQI fell to 1.89 (SD 2.97, n = 60) in biologic-naive and 3.43 (SD 5.81, n = 44) in biologic-experienced patients. The minimal clinically important difference for DLQI is ≥ 4-point reduction, which was reached within 6 months and maintained to 24 months in both cohorts. Limitations in the BADBIR registry meant data were only available for patients with scores documented during clinical visits. Additionally, there were no comparator data as only risankizumab data were available from BADBIR. In conclusion, sustained skin clearance was observed in both biologic-naive and biologic-experienced patients, with greater benefits seen in biologic-naive patients. Significantly more biologic-naive patients achieved complete skin clearance within 2 years compared with biologic-experienced patients (56.5% vs. 30.8%, P < 0.001). Real-world UK data confirm high levels of skin clearance and sustained response with risankizumab, consistently with clinical trial data.