Efficacy and Safety of Switching to Picankibart from Non-interleukin-23 Subunit p19 Inhibitors in Patients with...

The long-term efficacy of biologics in psoriasis is compromised by primary or secondary resistance, and poor treatment adherence due to frequent dosing.

We assessed the efficacy and safety of switching to an interleukin-23 subunit p19 (IL23p19) inhibitor picankibart at 200 mg every 12 weeks, without a washout period, on skin clearance and quality of life (QoL) in patients with plaque psoriasis.

A total of 152 patients were enrolled, comprising 83 suboptimal responders (static Physician's Global Assessment [sPGA] ≥ 2 or body surface area [BSA] ≥ 3%) and 69 clinical responders (sPGA0/1 and BSA < 3%). More than 96% had received IL-17A inhibitors. Among suboptimal responders, 48.2% achieved sPGA 0/1 and BSA < 3% at week 16 (W16), and the percentage increased to 54.2% at W44. Among responders, 82.6% maintained their therapeutic response at W44. The Dermatology Life Quality Index was reduced by 68.8% in suboptimal responders and by 61.5% in responders from baseline to W44. The most common adverse event was upper respiratory tract infection (25.0%).

Directly switching to picankibart resulted in clinically meaningful improvements in both skin lesions and QoL among suboptimal responders. Moreover, the majority of responders maintained their therapeutic response throughout the trial, accompanied by further enhancements in QoL. Picankibart was well tolerated without any new safety signals.

ClinicalTrials.gov identifier, NCT05970978.