Risankizumab improves long-term outcomes in patients with palmoplantar pustulosis: Study

A new study published in The Journal of Dermatology revealed that patients with palmoplantar pustulosis (PPP) who were 18 years of age or older who received risankizumab therapy saw long-lasting improvements in their disease's signs and symptoms, and their safety profile was similar with previous safety findings from other psoriasis risankizumab trials.

Palmoplantar pustulosis is typified by recurrent flare-ups and remissions and mostly affects women, and patients frequently have a history of localized infection and smoking. According to estimates, the prevalence of PPP in the Japanese population is 0.12%, greater than that of other affluent nations. Up to 30% of individuals with PPP (mostly women) have pustulotic arthro-osteitis (PAO) which is a serious comorbidity.

A humanized immunoglobin G1 monoclonal antibody called risankizumab (RZB) binds to the p19 component of IL-23 to selectively block it. Psoriatic arthritis, psoriasis vulgaris, erythrodermic psoriasis, generalized pustular psoriasis, and PPP in adults are among the conditions for which it is authorized in Japan. From the JumPPP research, this investigation was set to assess RZB in adult Japanese subjects with moderate-to-severe palmoplantar pustulosis.

This study reports the safety and effectiveness of risankizumab, an interleukin 23 p19 inhibitor. At weeks 0 and 4, participants were randomized 1:1 to receive RZB (150 mg) or a placebo. And, from week 16 to week 52 (for patients first assigned to RZB) or week 56 (for patients initially randomized to placebo), all patients received RZB. A Palmoplantar Pustulosis Area and Severity Index (PPPASI) change from baseline was the main outcome, and at week 16, there was a ≥50%/≥75% improvement in PPPASI (PPPASI 50/75). Safety and efficacy were assessed at 76 and 68 weeks, respectively.

A total of 119 individuals were recruited (n = 61 for RZB and n = 58 for placebo). The substantial difference in PPPASI change from baseline at week 16 indicated greater improvement with RZB when compared to placebo. At week 16, a higher percentage of patients who received RZB than those who received a placebo attained PPPASI 50, but not PPPASI 75. In general, improvements persisted until week 68.

The safety profile was mostly in line with other research on RZB's effects on psoriasis. Overall, in Japanese patients with PPP, RZB was shown to be more effective than a placebo at week 16, and benefits persisted until week 68. It was also well tolerated and showed no unanticipated safety effects.

Source:

Okubo, Y., Murakami, M., Kobayashi, S., Tsuji, S., Kishimoto, M., Ikeda, K., Jibiki, M., Neimark, E., Padilla, B., Shen, J., Peters, S., & Terui, T. (2025). Risankizumab in Japanese patients with moderate‐to‐severe palmoplantar pustulosis: Results from the randomized, phase 3 JumPPP study. The Journal of Dermatology. https://doi.org/10.1111/1346-8138.17659