Risankizumab (SKYRIZI®) Achieves Primary and All Secondary Endpoints in Phase 3 Induction Study in Patients With Ulcerative Colitis

Rhea-AI Summary

AbbVie announced positive results from the Phase 3 INSPIRE study for risankizumab (SKYRIZI), an IL-23 inhibitor for ulcerative colitis. At week 12, 20.3% of patients on risankizumab achieved clinical remission, compared to 6.2% on placebo (p<0.00001). All secondary endpoints, including endoscopic and histologic improvements, were met, with significant differences noted: 36.5% of risankizumab patients showed endoscopic improvement versus 12.1% for placebo. The safety profile was consistent with previous studies, with no new safety risks identified. The maintenance study for ulcerative colitis is ongoing, and the drug is currently not FDA-approved for this indication.

Positive

• 20.3% of patients on risankizumab achieved clinical remission vs 6.2% on placebo.
• All secondary endpoints met, including notable endoscopic improvement (36.5% vs 12.1%).
• Safety profile consistent with prior studies, no new safety risks observed.

Negative

• Risankizumab is not approved for ulcerative colitis, limiting immediate market impact.
• Ongoing maintenance study with no regulatory evaluation yet.

• A significantly higher proportion of patients with moderately to severely active ulcerative colitis treated with risankizumab achieved the primary endpoint of clinical remission^a (per Adapted Mayo Score) compared to placebo at week 12 in the Phase 3 INSPIRE induction study
• All secondary endpoints, including clinical, endoscopic and histologic outcomes, were met
• Safety results in this study were consistent with the known safety profile of risankizumab, with no new safety risks observed¹
• Building on AbbVie's growing gastroenterology portfolio, risankizumab is an IL-23 inhibitor being evaluated as a treatment for adults with moderate to severe ulcerative colitis and approved for Crohn's disease, psoriatic arthritis, and psoriasis¹

NORTH CHICAGO, Ill., March 23, 2023 /PRNewswire/ -- AbbVie (NYSE: ABBV) today announced positive top-line results from INSPIRE, a Phase 3 induction study, showing risankizumab (SKYRIZI^®,1200 mg intravenous [IV], at weeks 0, 4 and 8) met the primary endpoint of clinical remission (per Adapted Mayo Score) at week 12, as well as all secondary endpoints in adult patients with moderately to severely active ulcerative colitis.¹ In the study, 20.3% of patients receiving risankizumab achieved clinical remission compared to 6.2% of patients receiving placebo (p<0.00001).¹ The INSPIRE study enrolled patients that demonstrated intolerance or inadequate response to conventional therapies and/or advanced therapies (biologics, JAK inhibitors and S1P receptor modulators).¹ 

"Our commitment to people living with gastroenterological conditions continues to grow," said Roopal Thakkar, M.D., senior vice president, development, regulatory affairs and chief medical officer, AbbVie. "These encouraging results help support the potential risankizumab has to improve clinical, endoscopic and histologic outcomes in patients with ulcerative colitis."

A significantly greater proportion of patients treated with risankizumab achieved endoscopic improvement at week 12 compared to placebo (36.5% vs 12.1%; p<0.00001).¹ Furthermore, 24.5% of patients treated with risankizumab achieved histologic-endoscopic mucosal improvement at week 12 vs 7.7% of those receiving placebo (p<0.00001).¹ 

"It is impressive to see the meaningful responses that were achieved in the INSPIRE study, which demonstrates the potential of risankizumab to serve as an option across inflammatory bowel diseases," said Edouard Louis, M.D., Ph.D., professor and head of the department of gastroenterology, University Hospital CHU of Liège Belgium, INSPIRE study investigator. "These results suggest that risankizumab may help patients coping with the challenging symptoms of ulcerative colitis, which include abdominal pain, bowel urgency and fecal incontinence."

Efficacy Results at Week 12*,1
	Risankizumab 1200 mg IV (n=650)	Placebo (n=325)
Clinical Remission (Adapted Mayo Score)a	20.3 %	6.2 %
Clinical Response (Adapted Mayo Score)b	64.3 %	35.7 %
Endoscopic Improvementc	36.5 %	12.1 %
Histologic-Endoscopic Mucosal Improvementd	24.5 %	7.7 %

* Primary endpoint was clinical remission (per Adapted Mayo Score). Clinical response (per Adapted Mayo Score), endoscopic improvement and histologic-endoscopic mucosal improvement were secondary endpoints. Not all secondary endpoints are shown. All primary and secondary endpoints in this study achieved statistical significance under the overall type I error rate at 0.05 (2-sided). a Clinical remission per Adapted Mayo Score is defined as stool frequency subscore (SFS) ≤1 and not greater than baseline, rectal bleeding subscore (RBS) of 0 and endoscopic subscore ≤1 without friability.

b Clinical response per Adapted Mayo Score is defined as a decrease from baseline in the Adapted Mayo score ≥2 points and ≥30% from baseline, plus a decrease in RBS ≥1 or an absolute RBS ≤1.

c Endoscopic improvement is defined as endoscopic subscore ≤1 without friability. d Histologic-endoscopic mucosal improvement is defined as Geboes score ≤3.1 and endoscopic subscore ≤1 without friability.

During the 12-week, double-blind, placebo-controlled period, the safety profile of risankizumab 1200 mg IV was consistent with the safety profile observed in previous studies across other indications, with no new safety risks observed.¹ The most common adverse events observed in the risankizumab group were COVID-19, anemia and arthralgia. Serious adverse events occurred in 2.3% of patients in the risankizumab 1200 mg IV group compared to 10.2% of patients in the placebo group.¹ Rates of serious infections were 0.6% in those treated with risankizumab 1200 mg IV and 1.2% in patients who received placebo.¹ There was one death in the risankizumab 1200 mg group due to COVID-19 pneumonia on study day 33. There were no adjudicated major adverse cardiac events (MACE), no adjudicated anaphylactic reaction events and no malignancy events reported in the risankizumab group.¹

Use of risankizumab in ulcerative colitis is not approved and its safety and efficacy have not been evaluated by regulatory authorities. The maintenance study for ulcerative colitis is ongoing.

Risankizumab (SKYRIZI) is part of a collaboration between Boehringer Ingelheim and AbbVie, with AbbVie leading development and commercialization globally.

About Ulcerative Colitis

Ulcerative colitis is a chronic, idiopathic, immune-mediated inflammatory bowel disease (IBD) of the large intestine that causes continuous mucosal inflammation extending, to a variable extent, from the rectum to the more proximal colon.^2,3 The hallmark signs and symptoms of ulcerative colitis include rectal bleeding, abdominal pain, bloody diarrhea, tenesmus (a sense of pressure), urgency and fecal incontinence.^3,4 The disease course of ulcerative colitis varies between patients and can range from quiescent disease to chronic refractory disease, which in some cases can lead to surgery or complications, including cancer or death.^4,5 The severity of symptoms and unpredictability of disease course can lead to substantial burden and often disability among those living with the disease.⁶

About INSPIRE¹

INSPIRE is a multicenter, randomized, double-blind, placebo-controlled Phase 3 study evaluating the efficacy and safety of risankizumab 1200 mg IV administered every four weeks as induction therapy in subjects with moderately to severely active ulcerative colitis.

The primary endpoint is clinical remission (per adapted Mayo Score, defined as SFS ≤1 and not greater than baseline, RBS of 0 and endoscopic subscore ≤1 without friability) at week 12. Secondary endpoints include clinical response (decrease from baseline in the Adapted Mayo score ≥2 points and ≥30% from baseline, plus a decrease in RBS ≥1 or an absolute RBS ≤1), endoscopic improvement (endoscopic subscore ≤1 without friability), and histologic endoscopic mucosal improvement (HEMI, endoscopic subscore of 0 or 1 without friability and Geboes score ≤3.1) at week 12. More information can be found on www.clinicaltrials.gov (NCT03398148).

About Risankizumab (SKYRIZI^®)

SKYRIZI is an interleukin-23 (IL-23) inhibitor that selectively blocks IL-23 by binding to its p19 subunit.⁷ IL-23, a cytokine involved in inflammatory processes, is thought to be linked to a number of chronic immune-mediated diseases.⁸ SKYRIZI is approved by the U.S. Food and Drug Administration (FDA) and the European Medicines Agency for the treatment of plaque psoriasis, psoriatic arthritis and Crohn's disease. Phase 3 trials of SKYRIZI in psoriasis, psoriatic arthritis, Crohn's disease and ulcerative colitis are ongoing.^8,9,10

U.S. Indications and Important Safety Information about SKYRIZI^® (risankizumab-rzaa)¹¹
SKYRIZI is a prescription medicine used to treat adults with:

• moderate to severe plaque psoriasis who may benefit from taking injections or pills (systemic therapy) or treatment using ultraviolet or UV light (phototherapy).
• active psoriatic arthritis (PsA).
• moderate to severe Crohn's disease.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about SKYRIZI® (risankizumab-rzaa)?

SKYRIZI is a prescription medication that may cause serious side effects, including:

Serious Allergic Reactions:
Stop using SKYRIZI and get emergency medical help right away if you get any of the following symptoms of a serious allergic reaction:

• Fainting, dizziness, feeling lightheaded (low blood pressure)
• Swelling of your face, eyelids, lips, mouth, tongue, or throat
• Trouble breathing or throat tightness
• Chest tightness
• Skin rash, hives
• Itching

Infections: SKYRIZI may lower the ability of your immune system to fight infections and may increase your risk of infections. Your healthcare provider should check you for infections and tuberculosis (TB) before starting treatment with SKYRIZI and may treat you for TB before you begin treatment with SKYRIZI if you have a history of TB or have active TB. Your healthcare provider should watch you closely for signs and symptoms of TB during and after treatment with SKYRIZI.

• Tell your healthcare provider right away if you have an infection or have symptoms of an infection, including:
• fever, sweats, or chills
• muscle aches
• weight loss
• cough
• warm, red, or painful skin or sores on your body different from your psoriasis
• diarrhea or stomach pain
• shortness of breath
• blood in your mucus (phlegm)
• burning when you urinate or urinating more often than normal

Do not use SKYRIZI if you are allergic to risankizumab-rzaa or any of the ingredients in SKYRIZI. See the Medication Guide or Consumer Brief Summary for a complete list of ingredients. 

Before using SKYRIZI, tell your healthcare provider about all of your medical conditions, including if you:

• have any of the conditions or symptoms listed in the section "What is the most important information I should know about SKYRIZI?"
• have an infection that does not go away or that keeps coming back.
• have TB or have been in close contact with someone with TB.
• have recently received or are scheduled to receive an immunization (vaccine). Medicines that interact with the immune system may increase your risk of getting an infection after receiving live vaccines. You should avoid receiving live vaccines right before, during, or right after treatment with SKYRIZI. Tell your healthcare provider that you are taking SKYRIZI before receiving a vaccine.
• are pregnant or plan to become pregnant. It is not known if SKYRIZI can harm your unborn baby.
• are breastfeeding or plan to breastfeed. It is not known if SKYRIZI passes into your breast milk.
• become pregnant while taking SKYRIZI. You are encouraged to enroll in the Pregnancy Registry, which is used to collect information about the health of you and your baby. Talk to your healthcare provider or call 1-877-302-2161 to enroll in this registry.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

What are the possible side effects of SKYRIZI?
SKYRIZI may cause serious side effects. See "What is the most important information I should know about SKYRIZI?"

Liver problems in people with Crohn's disease: A person with Crohn's disease who received SKYRIZI by intravenous infusion developed changes in liver blood tests with a rash that led to hospitalization. Your doctor will do blood tests to check your liver before, during, and up to 12 weeks of treatment and may stop treatment with SKYRIZI if you develop liver problems. Tell your doctor right away if you notice any of the following symptoms: unexplained rash, nausea, vomiting, stomach(abdominal) pain, tiredness(fatigue), loss of appetite, yellowing of the skin and eyes (jaundice) and dark urine.

The most common side effects of SKYRIZI in people treated for Crohn's Disease include: upper respiratory infections, headache, joint pain, stomach (abdominal) pain, injection site reactions, low red blood cells (anemia), fever, back pain, and urinary tract infection.

The most common side effects of SKYRIZI in people treated for plaque psoriasis and psoriatic arthritis include: upper respiratory infections, headache, feeling tired, injection site reactions, and fungal skin infections.

These are not all the possible side effects of SKYRIZI. Call your doctor for medical advice about side effects.

Use SKYRIZI exactly as your healthcare provider tells you to use it.

SKYRIZI is available in a 150 mg/mL prefilled syringe and pen, a 600mg/10mL intravenous infusion, and a 360mg/2.4mL single-dose prefilled cartridge with on-body injector.

This is the most important information to know about SKYRIZI. For more information, talk to your HCP.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.

If you are having difficulty paying for your medicine, AbbVie may be able to help. Visit AbbVie.com/myAbbVieAssist to learn more.

Please click here for Full Prescribing Information and Medication Guide for SKYRIZI.

Globally, prescribing information varies; refer to the individual country product label for complete information.

About AbbVie in Gastroenterology

With a robust clinical trial program, AbbVie is committed to cutting-edge research to drive exciting developments in inflammatory bowel diseases (IBD), like ulcerative colitis and Crohn's disease. By innovating, learning and adapting, AbbVie aspires to eliminate the burden of IBD and make a positive long-term impact on the lives of people with IBD. For more information on AbbVie in gastroenterology, visit https://www.abbvie.com/our-science/therapeutic-focus-areas/immunology/immunology-focus-areas/gastroenterology.html.

About AbbVie

AbbVie's mission is to discover and deliver innovative medicines that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas: immunology, oncology, neuroscience, eye care, virology, women's health and gastroenterology, in addition to products and services across its Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at www.abbvie.com. Follow @abbvie on Twitter, Facebook, LinkedIn or Instagram.

Forward-Looking Statements

Some statements in this news release are, or may be considered, forward-looking statements for purposes of the Private Securities Litigation Reform Act of 1995. The words "believe," "expect," "anticipate," "project" and similar expressions, among others, generally identify forward-looking statements. AbbVie cautions that these forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from those indicated in the forward-looking statements. Such risks and uncertainties include, but are not limited to, failure to realize the expected benefits from AbbVie's acquisition of Allergan plc ("Allergan"), failure to promptly and effectively integrate Allergan's businesses, competition from other products, challenges to intellectual property, difficulties inherent in the research and development process, adverse litigation or government action, changes to laws and regulations applicable to our industry and the impact of public health outbreaks, epidemics or pandemics, such as COVID-19. Additional information about the economic, competitive, governmental, technological and other factors that may affect AbbVie's operations is set forth in Item 1A, "Risk Factors," of AbbVie's 2021 Annual Report on Form 10-K, which has been filed with the Securities and Exchange Commission, as updated by its subsequent Quarterly Reports on Form 10-Q. AbbVie undertakes no obligation to release publicly any revisions to forward-looking statements as a result of subsequent events or developments, except as required by law.

References:

1. AbbVie. Data on file: ABVRRTI75696.
2. Gajendran M, Loganathan P, Jimenez G, et al. A comprehensive review and update on ulcerative colitis. Dis Mon. 2019 Dec;65(12):100851. doi: 10.1016/j.disamonth.2019.02.004
3. The facts about inflammatory bowel diseases. Crohn's & Colitis Foundation of America. Accessed March 8, 2023.  https://www.crohnscolitisfoundation.org/sites/default/files/2019-02/Updated%20IBD%20Factbook.pdf
4. Ulcerative colitis. Mayo Clinic. Accessed March 3, 2023. https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/symptoms-causes/syc-20353326
5. Monstad, I, Hovde O, Solberg IC, A Moum B. Clinical course and prognosis in ulcerative colitis: results from population-based and observational studies. Ann Gastroenterol. 2014; 27(2): 95–104.
6. Mehta F. Report: economic implications of inflammatory bowel disease and its management. Am J Manag Care. 2016;22(3 Suppl):s51-60.
7. Duvallet E, Sererano L, Assier E, Falgarone G, Boissier MC. Interleukin-23: a key cytokine in inflammatory diseases. Ann Med. 2011;43(7):503-11. doi:10.3109/07853890.2011.577093
8. Pipeline. AbbVie. 2021. Accessed March 3, 2023. https://www.abbvie.com/our-science/pipeline.html
9. A study comparing risankizumab to placebo in participants with active psoriatic arthritis including those who have a history of inadequate response or intolerance to biologic therapy(ies) (KEEPsAKE2). ClinicalTrials.gov. Updated February 28, 2023. Accessed March 3, 2023. https://clinicaltrials.gov/ct2/show/NCT03671148
10. A multicenter, randomized, double-blind, placebo controlled induction study to evaluate the efficacy and safety of risankizumab in participants with moderately to severely active ulcerative colitis. ClinicalTrials.gov. Updated March 10, 2023. Accessed March 12, 2023. https://clinicaltrials.gov/ct2/show/record/NCT03398148
11. SKYRIZI [package insert]. North Chicago, IL: AbbVie Inc.; 2022.

 

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SOURCE AbbVie

FAQ

What were the results of the Phase 3 INSPIRE study for ABBV's risankizumab?

The INSPIRE study showed that 20.3% of patients taking risankizumab achieved clinical remission at week 12, compared to 6.2% on placebo.

What are the secondary endpoints met in the INSPIRE study for ABBV?

All secondary endpoints were achieved, including significant endoscopic and histologic improvements.

Is risankizumab approved for ulcerative colitis by ABBV?

No, risankizumab is not currently approved for ulcerative colitis treatment.

What is the safety profile of risankizumab according to ABBV's study?

The safety profile was consistent with previous studies, showing no new safety risks.

What is the next step after the INSPIRE study results for ABBV?

The maintenance study for ulcerative colitis is ongoing.