Advances in Treating High-Impact Psoriasis from EADV 2026

Risankizumab (Skyrizi, AbbVie) maintained clear or almost clear skin in roughly 8 in 10 patients with genital psoriasis (PsO) and about 3 in 4 with scalp psoriasis through 52 weeks, with no new safety signals, according to Christopher G. Bunick, MD, PhD, associate professor of dermatology and of translational biomedicine at Yale School of Medicine. Bunick discussed the week-52 results of the phase 4 UnlIMMited trial (NCT05969223), which have not yet been peer-reviewed and were first presented at the EADV Symposium in Athens, Greece, May 7–9, 2026, in an interview with HCPLive at the 2026 European Academy of Dermatology and Venereology (EADV) Congress in Vienna, Austria, held September 30-October 3.¹

UnlIMMited comprises 2 studies, Study-G in genital PsO and Study-S in scalp PsO. Patients were randomized 1:1 to risankizumab 150 mg or placebo at weeks 0 and 4, then all entered an open-label extension at week 16, receiving risankizumab 150 mg every 12 weeks through week 52.¹ At week 16, 69.1% of patients with genital PsO on risankizumab achieved a static Physician's Global Assessment-Genital (sPGA-G) score of 0 or 1 versus 13.0% with placebo (P < .0001).²

At week 52 in Study-G, 81.5% of patients continuing risankizumab and 75.5% of those who switched from placebo had sPGA-G 0/1.¹ Dermatology Life Quality Index scores of 0 or 1 were reached by 57.4% and 50.9%, respectively, and a clinically meaningful genital itch improvement (at least a 4-point numeric rating scale gain) by 80.5% and 55.6%.¹ Minimal or no interference with sexual activity (GenPs-SFQ item 2 score of 0 or 1) was reported by 77.4% and 84.4%.¹

"We don't talk about this in the office with our psoriasis patients, but it's affecting their life in a tremendous way," Bunick said of sexual health.

In Study-S, scalp Investigator Global Assessment 0/1 was reached by 72.5% of continuing patients and 79.2% of switch patients at week 52, with complete clearance on the PsO Scalp Severity Index in 64.7% and 66.7%.¹ A symptom score of 0 was reported by 35.3% and 50.0%, and mean reductions in the scalp symptom score were about 7.7 and 7.5 points.¹

"I don't read too much into that. The point is, it's about three fourths of the patients, regardless of whether you started at the beginning or at week 16," Bunick said of the switch arm's slightly higher response.

Adverse-event profiles were similar across both studies, and Bunick said he is not overly concerned about infections or other events that would limit long-term use of a targeted IL-23 p19 biologic.

Bunick said that for small, high-impact areas, PsO Area and Severity Index scores are less informative than IGA scores paired with patient-reported outcomes. On sequencing, he noted that the oral IL-23 receptor peptide icotrokinra and p19-specific biologics all have scalp and genital data, including 1-year icotrokinra results. He said he favors a p19 biologic in his own clinic for adherence and cited a matching-adjusted indirect comparison suggesting risankizumab outperforms icotrokinra by about 10 to 20 percentage points on most outcomes, reserving the oral option for patients with focal disease or needle fear. "In the big scheme of things, the real winner is the patient that has scalp and genital psoriasis because they now have more than ever therapies that are effective and that can be used for their high-impact sites," he said. He named how to sequence therapy in biologic-experienced patients as the biggest remaining research gap, and pointed to next-generation tyrosine kinase 2 inhibitors such as zasocitinib as data to watch.

Relevant disclosures for Bunick include AbbVie, South Beach Symposium, Almirall, Apogee Therapeutics, Arcutis Biotherapeutics, Daiichi Sankyo, Eli Lilly, LEO Pharma, US, Novan, Novartis, Ortho Dermatologics, Palvella Therapeutics, Pfizer Inc., Sanofi, Sun Pharmaceutical Industries Ltd., Timber Pharmaceuticals, and UCB.

References

1. Safety and efficacy of risankizumab in genital and scalp psoriasis in the UnlIMMited phase 4 randomized clinical trial at week 52. Presented at: European Academy of Dermatology and Venereology (EADV) Symposium; May 7-9, 2026; Athens, Greece.

2. Song EJ, Ehst B, Glick B, et al. Efficacy and safety of risankizumab in genital or scalp psoriasis in the UnlIMMited phase 4 randomized clinical trial at week 16. Dermatol Ther (Heidelb). 2026;16(1):293-307. doi:10.1007/s13555-025-01544-6