Early response to vunakizumab and its baseline predictors in patients with moderate-to-severe plaque psoriasis: a post hoc analysis of a phase-III trial.

Background: Exploring predictors of early response is meaningful to optimize treatment strategies of patients with psoriasis. However, predictors of early response to vunakizumab remain unidentified.

Objective: This study aimed to investigate the early response rates to vunakizumab and identify predictors in patients with moderate-to-severe plaque psoriasis.

Methods: Data were derived from a phase-III trial (NCT04839016), and 461 patients with moderate-to-severe plaque psoriasis receiving vunakizumab were included. Early response was defined as ≥50% improvement in the Psoriasis Area Severity Index (PASI 50) by week 2 of treatment.

Results: A total of 54.0% of patients achieved early response. The proportion of males with early response (71.1%) was lower than males without that (82.5%) (p = 0.004). Regarding patients who had previous local treatment, the proportion of patients with early response (77.1%) was lower than patients without that (85.4%) (p = 0.024). Male [adjusted odds ratio (OR)=0.558, p = 0.027] and previous local treatment (adjusted OR = 0.586, p = 0.039) independently predicted lower possibility of early response. The nomogram demonstrated good calibration performance (mean absolute error: 0.021) with a limited discriminative ability (C-index: 0.580).

Conclusion: Early response rate to vunakizumab was 54.0% in patients with moderate-to-severe plaque psoriasis, where female gender and naïve status to local therapy predicted early response.