IMMpactful: Risankizumab Outperforms Deucravacitinib in Moderate Psoriasis at 16 Weeks

Key Takeaways

• Risankizumab demonstrated higher rates of skin clearance than deucravacitinib at week 16 in patients with moderate plaque psoriasis, new results from the IMMpactful trial suggested. 
• Greater proportions of patients on risankizumab achieved symptom relief (PSS 0/1) and improved quality of life (DLQI 0/1).
• Improvements in symptoms and QoL increased with higher PASI response levels across both treatment groups.

Risankizumab achieved higher rates of PASI 90 and PASI 100 compared with deucravacitinib at 16 weeks, alongside greater improvements in patient-reported symptoms and quality of life, new results from the IMMpactful trial suggested.

The new research, presented at the 2026 American Academy of Dermatology Annual Meeting, included 393 biologic-naïve patients with moderate plaque psoriasis (body surface area 10% to 15% and PASI ≥12) who were candidates for systemic therapy. Participants received risankizumab (n = 131) or deucravacitinib (n = 262). Primary outcomes assessed at 16 weeks  included PASI 90 and PASI 100, as well as patient-reported endpoints: Psoriasis Symptom Scale (PSS) 0/1 and Dermatology Quality of Life Index (DLQI) 0/1.

According to the new data, risankizumab was associated with higher response rates across all endpoints vs deucravacitinib at week 16, including PASI 90 (57.3% vs 22.9%, P < .0001) and PASI 100 (27.5% vs 6.5%, P < 0.0001). Similarly, more patients receiving risankizumab achieved PSS 0/1 (58.0% vs 26.3%, nominal P < 0.0001) and DLQI 0/1 (64.1% vs 30.5%, nominal P < 0.0001).

Increasing skin clearance levels were associated with higher rates of symptom resolution and quality-of-life improvement across PASI response strata. Among risankizumab-treated patients, PSS 0/1 rates increased from 28.6% in those with PASI < 75 to 80.6% in those achieving PASI 100; similar trends were observed for DLQI 0/1 (33.3% to 80.6%). Comparable trends were reported with deucravacitinib. Cited limitations included the short-term follow-up and underpowered subgroup analyses.

“Patients with moderate plaque psoriasis treated with RZB achieved higher skin clearance than those treated with DEU. Higher skin clearance resulted in increased symptom relief and better QoL,” the authors wrote.

Source: Soung J, Magnolo N, Frew J, Constanzo A, Moore AY, Xie J, Kaplan B, Stakias V, Espaillat R, Manish Patel M, Warren RB. Effect of Risankizumab Versus Deucravacitinib on Psoriasis-Related Symptoms and Quality of Life in Patients With Moderate Plaque Psoriasis: Results From the IMMpactful Trial at Week 16. Poster 73341. Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver.