Risankizumab in Psoriasis: Real-World Effectiveness, Safety, and Clinical Outcomes
Related Experiment Video
Updated: Oct 31, 2026
Measuring Psoriasis Severity at Home
Published on: March 1, 2024
Maha Alkofide1, Abdulaziz Madani1, Sarah Alsukait1
1Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Background:
Risankizumab (anti-IL-23 p19) is an established therapy for moderate-to-severe psoriasis, with strong trial efficacy and growing real-world evidence. However, long-duration outcomes and treatment-spacing patterns from the Gulf region remain limited.
Objective:
To evaluate long-term effectiveness, safety, and treatment patterns-including extended-interval dosing-of Risankizumab in a real-world tertiary center.
Methods:
Single-center retrospective cohort of adults treated with Risankizumab between January 2020 and January 2025. Primary outcome: Psoriasis Area and Severity Index (PASI) 100 on last visit. Secondary outcomes: changes in Psoriasis Area and Severity Index (PASI), body surface area (BSA), and Dermatology Life Quality Index (DLQI) and Nail Psoriasis Severity Index (NAPSI); adverse events; treatment persistence and dosing intervals. Non-parametric tests were used; predictors of PASI 100 were explored with multivariable logistic regression.
Results:
We included 144 patients (mean age 39.3±14.9 years; 55.6% male; mean BMI 29.0±6.5). At last visit, 61.1% achieved PASI 100. Mean scores improved from baseline to last visit: PASI 7.24→0.34, BSA 9.81%→0.26%, DLQI 7.64→0.68, NAPSI 9.56→2.94 (all p<0.001). Adverse events were infrequent (3.5%), all mild; no major adverse cardiovascular events or deaths occurred. A single case of lung cancer was reported and considered unlikely to be treatment related. A quarter of patients transitioned to extended intervals (most commonly every 4-6 months), with the majority maintaining disease control and relapse occurring infrequently and only after ≥6 months. Longer treatment duration and maintenance of standard dosing frequency were associated with achieving PASI 100, while positive family history was associated with lower odds of complete clearance.
Conclusion:
In routine practice, Risankizumab achieved high complete-clearance rates with excellent tolerability over ~31 months' mean exposure. Extended-interval dosing was feasible in selected stable responders. These findings align with trial durability and regional registry signals and support individualized long-term strategies.
