RISANKIZUMAB delivered sustained psoriasis clearance and reduced subclinical inflammation on OCT imaging across 52 weeks follow-up.
Risankizumab Long-Term Effects in Psoriasis on OCT
Risankizumab, an IL-23 inhibitor, is known to achieve rapid skin clearance in moderate-to-severe psoriasis, but longer-term effects beneath the skin surface are less well defined. In a prospective, single-center exploratory sub-analysis, researchers followed 22 patients treated with risankizumab and paired standard clinical outcomes with optical coherence tomography (OCT), a non-invasive imaging technique that can capture structural and vascular changes in real time.
Clinical severity was assessed using Psoriasis Area and Severity Index (PASI), Investigator’s Global Assessment (IGA), and Body Surface Area (BSA) at baseline and serial timepoints through Week 52. OCT imaging was performed at baseline and Weeks 4, 16, and 52, focusing on epidermal thickness and vascular parameters including vessel density and vessel diameter in lesional and perilesional skin.
Clinical Improvement Over 52 Weeks
Clinical scores improved early and remained favorable throughout follow-up. By Week 16, mean PASI fell from 16.3 at baseline to 3.5, alongside a marked reduction in BSA involvement from 24.7% to 5.2%. By Week 52, 86.7% of patients achieved PASI 75, 73.3% achieved PASI 90, and 40.0% achieved PASI 100. Most participants also reached near-complete clearance on IGA, with 93.3% recorded as IGA 0/1.
OCT Signals Reduced Subclinical Inflammation
OCT findings suggested treatment effects beyond visible clearance. Over 52 weeks, lesional epidermal thickness decreased by 37.4%, vessel density fell by 26.6% (ΔAUC), and vessel diameter reduced by 59.5% (ΔAUC). Notably, vascular changes were also detected in uninvolved perilesional skin, supporting the idea that risankizumab’s long-term effects in psoriasis may include improvements in deeper, subclinical inflammatory activity.
Taken together, the results position OCT as a useful adjunct for evaluating “deep” treatment response, complementing PASI, IGA, and BSA in long-term psoriasis management.
Reference: Zirpel H et al. Evaluating Risankizumab’s Long-Term Effects in Psoriasis Using Optical Coherence Tomography. Dermatol Ther (Heidelb). 2026;doi:10.1007/s13555-025-01637-2.
