Real-World Switch Rates for Patients With Psoriasis Initiating Risankizumab Stratified by Body Mass Index

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Introduction: Psoriasis (PsO) is a chronic, inflammatory skin disorder that affects 1%–4% of adults in the US. While PsO typically affects the skin, it is also associated with other systemic comorbidities, such as psoriatic arthritis, cardiometabolic disease, diabetes, and obesity. Switching therapies is common in patients with PsO due to poor treatment outcomes, such as lack of efficacy or safety/tolerability issues that are notably more pronounced in refractory patients. This study aims to quantify real-world switch rates for patients with PsO treated with risankizumab, stratified by body mass index (BMI) categories.
 Methods: The Optum® Market Clarity data, which includes insurance claims linked with electronic medical records data, was used to identify biologic-naïve adult patients who initiated risankizumab between May 1, 2019 and September 30, 2022, with ≥1 PsO diagnosis (ICD codes) on or prior to biologic initiation. Patients had ≥6 months of continuous insurance benefits pre- and ≥12 months post-biologic initiation, and BMI data available on or in the 12 months before the start of risankizumab. Assessed outcomes included switch rates over 12 months among all risankizumab initiators and stratified by BMI category (BMI <25 Kg/m2, 25 to <30 Kg/m2, ≥30 Kg/m2).
 Results: A total of 367 patients were included in this analysis. The mean (SD) age of patients was 47.7 (14.3) years, 194 (52.9%) were female, 20 (5.5%) were Black, and 305 (83.1%) were White. Of all patients, 71 (19.4%) had a BMI of <25 Kg/m2, 111 (30.2%) had a BMI of 25 to <30 Kg/m2, and 185 (50.4%) had a BMI ≥30 Kg/m2. The switch rate by 12 months for all patients initiating risankizumab was 3.8%. Switch rates by BMI category were 5.6% (BMI <25 Kg/m2), 2.7% (BMI 25 to <30 Kg/m2), and 3.8% (BMI ≥30 Kg/m2); there were no significant differences in switch rates between BMI categories (P = 0.589 from Fisher's exact test).
 Conclusions: In this real-world study, treatment patterns through 12 months among patients initiating risankizumab were consistent regardless of BMI category.