Risankizumab Real World PsA Data From PERIS, With Fabian Proft, MD

Interim results through 6 months show improvements across joint, entheseal, and skin domains in a largely pretreated population.

As treatment options for psoriatic arthritis (PsA) expand, questions remain about how long patients continue advanced therapies in routine clinical practice, particularly when treatment targets are not achieved. Interim results from the PERIS study, presented at the American College of Rheumatology (ACR) Convergence 2026 in Orlando, Florida, describe improvements across multiple PsA domains among patients receiving risankizumab (Skyrizi) through 6 months.¹

Fabian Proft, MD, a rheumatologist at Charité University Hospital Berlin in Germany and an author on the study, discussed the rationale for the analysis, the patients enrolled, and what clinicians can take from the early data in an interview with HCPLive.

Treatment Persistence as a Real-World Marker in Psoriatic Arthritis

“With the growing treatment armamentarium in psoriatic arthritis, we have multiple options available, but this can also lead to rapid cycling or switching between therapies, especially as a significant number of patients are still not reaching the treatment targets we are aiming for,” Proft said.

Proft described drug persistence as an indicator of whether patients and treating physicians are satisfied with a therapy. Previous real-world research has examined treatment continuation through drug survival analyses, including 3-year VALUE data in patients with psoriasis and comorbid PsA.

PERIS is an ongoing, prospective, multicountry observational study conducted outside the US. The study plans to enroll 900 to 1200 participants across approximately 15 countries, with a planned 2:1 allocation of patients receiving risankizumab versus other advanced therapies.² Its primary outcome is treatment persistence through 24 months, defined by whether participants remain on their prescribed therapy.

Treatment decisions were made before and independently of enrollment, with patients assessed every 3 months through month 24 according to local practice.¹ Unlike a randomized clinical trial, PERIS evaluates treatments selected during routine care.

PERIS Enrolled Pretreated Patients With Active PsA

Proft explained how differences between clinical trial eligibility criteria and routine clinical practice informed the study's observational design.

The interim analysis included 141 patients receiving risankizumab, of whom 137 completed the month 6 visit and 4 discontinued treatment before month 6.¹ More than half (58.9%) had prior exposure to a biologic disease-modifying antirheumatic drug (bDMARD). Mean disease duration was 5.8 years, and mean clinical Disease Activity index for Psoriatic Arthritis (cDAPSA) was 22.3 at baseline, with no patients in remission.

“When looking at the baseline characteristics, what stands out is that, especially in the IL-23 arm, patients experienced a lot of treatments before they were put on risankizumab in this study,” Proft said.

The findings describe a population with established disease and substantial prior biologic exposure, although the study's observational design and eligibility criteria limit direct comparisons with randomized trial populations.

Risankizumab Associated With Improvements in Joint, Enthesitis, and Skin Outcomes

At month 6, the proportion of patients achieving low disease activity or remission by cDAPSA increased from 15.6% at baseline to 64.8%, while the proportion with high disease activity declined from 26.2% to 3.7%.¹

Minimal disease activity was achieved by 20.6% of patients at month 3 and 34.4% at month 6.

Improvements were also reported across individual disease domains. Mean tender joint count decreased by 3.98, and mean swollen joint count decreased by 1.74 at month 6. Among patients with enthesitis at baseline, 70.8% achieved resolution by month 6, while 50% of patients with baseline dactylitis achieved resolution. Among patients with baseline body surface area (BSA) involvement greater than 3%, 71.4% achieved BSA involvement of 3% or less.

Proft emphasized the importance of evaluating multiple disease manifestations in PsA, including peripheral joints, skin, nails, entheses, digits, and the axial skeleton.

He also discussed the potential comparative effectiveness of risankizumab relative to tumor necrosis factor (TNF) and interleukin 17 (IL-17) inhibitors. However, the presented interim abstract reports effectiveness outcomes for the risankizumab cohort only and does not provide comparative estimates against other advanced therapies.¹

As a result, the 6-month findings describe changes observed during risankizumab treatment but do not establish comparative effectiveness or demonstrate superiority or equivalence to other treatment classes.

Axial PsA and 24-Month PERIS Follow-Up

Proft identified axial disease as an area of particular interest in evaluating interleukin 23 (IL-23) inhibition in PsA.

Interest in this domain has increased following the phase 4 STAR study of guselkumab (Tremfya), which enrolled 411 biologic-naive adults with magnetic resonance imaging (MRI)-confirmed axial PsA. According to topline results announced by Johnson & Johnson in September 2026, STAR met its primary endpoint of improvement in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) compared with placebo at week 24. The company also reported improvements in axial symptoms and MRI-assessed sacroiliac joint inflammation. Detailed numerical efficacy and safety results were not included in the announcement.³

Although Proft discussed the potential effectiveness of risankizumab in axial PsA and its possible relationship to outcomes observed with IL-17 and TNF inhibitors, axial-specific results were not reported in the PERIS interim abstract.¹ The findings therefore cannot establish risankizumab's effectiveness in axial disease or its comparative performance against other advanced therapies.

The planned 24-month follow-up will provide additional information about treatment persistence, the study's primary outcome, as well as longer-term effectiveness in routine clinical practice.

Proft indicated the completed study may help clarify differences between treatment approaches and inform future research into which patients may benefit from specific mechanisms of action. Whether the observational findings can identify clinically meaningful differences between therapies will depend on the final analyses and their ability to account for differences between treatment groups.

Editor's Note: Proft reports relevant disclosures with AbbVie, Alfasigma, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Galapagos, Hexal, Janssen, Medscape, MoonLake, MSD, Novartis, Pfizer, Roche, and UCB.

References

1. Selmi C, Vosvotekas G, Kougkas N, et al. Real-World Effectiveness of Risankizumab in Patients With Psoriatic Arthritis: 6-Month Interim Results From the Observational PErsistence With RISankizumab (PERIS) Study. Abstract 1326. Presented at: ACR Convergence 2026; November 6-11, 2026; Orlando, FL. https://acrabstracts.org/abstract/real-world-effectiveness-of-risankizumab-in-patients-with-psoriatic-arthritis-6-month-interim-results-from-the-observational-persistence-with-risankizumab-peris-study/

2. An Ex-US Study to Assess Treatment Persistence With Risankizumab in Adult Participants With Psoriatic Arthritis (PERIS). ClinicalTrials.gov identifier: NCT06764693. Updated February 12, 2026. https://clinicaltrials.gov/study/NCT06764693

3. Johnson & Johnson. Johnson & Johnson Announces TREMFYA (guselkumab) Is the First and Only IL-23 Inhibitor to Show Significant Improvement in Spinal Pain and Stiffness in Landmark Axial Psoriatic Arthritis (PsA) Study. Press release. Published September 25, 2026. https://investor.jnj.com/investor-news/news-details/2026/Johnson--Johnson-announces-TREMFYA-guselkumab-is-the-first-and-only-IL-23-inhibitor-to-show-significant-improvement-in-spinal-pain-and-stiffness-in-landmark-axial-psoriatic-arthritis-PsA-study/default.aspx