Matching-Adjusted Indirect Comparison of Risankizumab Versus Icotrokinra in Adult Patients with Moderate-to-Severe...

Risankizumab (RZB) is an approved injectable IL-23 inhibitor with demonstrated high levels of skin clearance, and icotrokinra (ICO) is an oral IL-23 receptor blocker recently approved for the treatment of moderate-to-severe plaque psoriasis. In the absence of head-to-head trials, this study uses matching-adjusted indirect comparison (MAIC) to compare RZB with ICO in the treatment of adult patients with moderate-to-severe psoriasis.

Individual patient data from phase 3 RZB trials and summary data from published ICO phase 3 trials were used in this MAIC through week 52. Risk differences between RZB and ICO placebo-adjusted response rates (anchored) were assessed for ≥ 75%, ≥ 90%, and 100% improvement in Psoriasis Area and Severity Index (PASI 75, PASI 90, and PASI 100) and Investigator's Global Assessment (IGA) of 0 and 0/1 (IGA 0 and IGA 0/1) every 4 weeks up to week 16. Risk differences between RZB and ICO unadjusted response rates (unanchored) at weeks 24 and 52, along with confidence intervals and P-values, are also presented.

At 16 weeks, the PBO-adjusted response rates (RZB versus ICO) were 80.6% versus 61.7%, with a risk difference (RD) of 18.9% (95% CI 11.5, 26.4; P < 0.001) for PASI 75; 71.4% versus 49.9% (RD: 21.5%; 95% CI 15.6, 27.4; P < 0.001) for PASI 90; 42.3% versus 29.4% (RD: 13.0%; 95% CI 7.9, 18.0; P < 0.001) for PASI 100; 77.8% versus 58.4% (RD: 19.4%; 95% CI 12.4, 26.3; P < 0.001) for IGA 0/1; and 41.6% versus 33.9% (RD: 7.7%; 95% CI 2.3, 13.0; P < 0.05) for IGA 0. Results were consistent in the unanchored analysis at weeks 24 and 52.

In this analysis, adult patients with moderate-to-severe psoriasis treated with RZB demonstrated greater clinical efficacy as early as week 4 or 8, and through week 52 compared with ICO.