Risankizumab Maintains Radiographic Nonprogression Through 5 Years in Psoriatic Arthritis
Five-year data from the phase 3 KEEPsAKE 1 trial show that risankizumab maintains low rates of radiographic progression in patients with active psoriatic arthritis (PsA), supporting its role in long-term structural disease control.
“In patients with psoriatic arthritis (PsA), chronic inflammation in joint tissues can result in structural damage that may impact physical function and lead to disability,” the investigators noted. This analysis aimed to evaluate long-term maintenance of radiographic nonprogression in patients treated with risankizumab.
Data were derived from the KEEPsAKE 1 phase 3 randomized, double-blind trial, including patients aged ≥18 years with active PsA and inadequate response or intolerance to at least 1 conventional synthetic disease-modifying antirheumatic drug. Radiographic progression was assessed using the modified Total Sharp Score (mTSS), with nonprogression defined as change from baseline (CFB) ≤0. Patients initially randomized to risankizumab (N=483) were followed through approximately 5 years (244 weeks), with imaging conducted at multiple timepoints.
Across the study period, radiographic progression remained minimal. Mean change in mTSS at week 244 was 0.93, indicating limited structural damage accumulation over time. The proportion of patients without radiographic progression remained consistently high, with 88.4% maintaining CFB mTSS ≤0 through 244 weeks.
Among patients who had no radiographic progression at week 52, outcomes were particularly durable. Mean CFB mTSS remained low (0.25), and 93.4% of these patients continued to show no radiographic progression through 5 years, suggesting sustained disease control once achieved.
“In this post hoc analysis, the proportion of patients receiving [risankizumab] that had no radiographic progression (as measured by mTSS ≤ 0) was high and consistent through 244 weeks,” the authors concluded. “The vast majority (≥ 90%) of patients without radiographic progression at week 52 maintained that outcome over 5 years.”
These findings reinforce the long-term structural benefits of risankizumab in PsA, particularly for biologic-naive patients, with sustained inhibition of joint damage progression over extended follow up.
Reference
Lonowski S, Khattri S, Talia J, et al. Long-term efficacy of risankizumab in maintenance of radiographic nonprogression in patients with active psoriatic arthritis: 5-year data from the KEEPsAKE 1 phase 3 trial. Presented at: American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, Colorado.
