Real-world effectiveness and drug retention rate of risankizumab in patients with psoriatic arthritis: data from the multicentre GIRRCS cohort

Introduction Psoriatic arthritis (PsA) is a chronic heterogenous inflammatory disease characterized by a multidomain burden. Risankizumab, a selective inhibitor of the IL-23 p19 subunit, has shown efficacy in randomized trials; however, real-world data in PsA remain limited. We evaluated the real-world effectiveness and treatment persistence of risankizumab in the GIRRCS cohort.Methods This observational study included 55 consecutive patients with moderate-to-active PsA treated with risankizumab between January 2022 and June 2025. The primary evaluation was 6-month change in Disease Activity Index for Psoriatic Arthritis (DAPSA), assessed using an age- and sex-adjusted linear mixed-effects model. Secondary assessment included longitudinal changes in joint counts, Leeds Enthesitis Index, VAS pain, patient global assessment, and CRP. Drug retention rate (DRR) was estimated by Kaplan-Meier analysis.Results Patients had long-standing disease (11.4 ± 9.6 years), mainly peripheral involvement, frequent enthesitis/axial disease, and prior biologic exposure (72.7%). DAPSA significantly improved at 6 months (β −9.1, 95%CI − 12.62 to −5.61; p < 0.001). Six-month response was similar between bDMARD-naïve and experienced patients, although earlier improvement at 3 months was observed in naïve individuals (p = 0.021). All secondary assessments improved (p < 0.001). Estimated 18-month DRR was 59.8%.Conclusions Risankizumab was associated with clinical benefit and acceptable treatment persistence, even if larger studies are needed.