Skyrizi (Risankizumab) - NICE Approves New Biologic for Psoriasis

Skyrizi (Risankizumab) has been recommended for the treatment of severe psoriasis in adults in England and Wales.

The National Institute for Health and Care Excellence (NICE) has today published its decision to recommend the biologic medicine, Skyrizi (also known by its generic name, Risankizumab), to treat severe plaque psoriasis in adults in England and Wales where the condition has not responded to systemic treatments (such as methotrexate, ciclosporin and phototherapy), or where these treatments cannot be tolerated by the patient.

This decision is the result of a fast track appraisal (FTA), a process which was first introduced in 2017 for technologies that offer exceptional value for money. According to NICE, the aim of fast track appraisals is 'to provide quicker access for patients to the most cost-effective new treatments.'

How does Skyrizi work?

Skyrizi blocks the activity of interleukin-23 (IL-23), a chemical ‘messenger’ in the immune system which signals other cells to cause inflammation. In people with psoriasis, the immune system is overactive and creates too much inflammation, which leads to the development of psoriasis symptoms. Skyrizi is very precise and binds to a specific part of the IL-23 messenger, called p19. This then blocks IL-23 from sending out the inflammation signals and processes, preventing some of the inflammation from occurring and leading to an improvement in psoriasis for some people who take it.

How is Skyrizi used?

Skyrizi is taken as an injection under the skin via a pre-filled syringe or pre-filled injection pen. The recommended dose is 150mg. When Skyrizi was launched you needed to have two injections of 75mg at each dose. However, from 9th July 2021 each injection will now contain the full dose (150mg) and so only one injection will be required each time. There will still be supplies of the two dose injections through to January 2022. The injections should be administered in areas such as the thighs or abdomen avoiding where the skin is tender, bruised or affected by psoriasis. If you are using the two-dose version of Skyrizi, the injections should be administered in separate body site locations e.g. the thigh and abdomen.

When you begin taking Skyrizi you will have your first injection(s), followed four weeks later by your next. After that Skyrizi is usually taken every 12 weeks. Most people will be trained by a nurse to give the injection to themselves.

People taking Skyrizi are likely to need regular blood tests – usually carried out by a Dermatology specialist, or by their own GP, to monitor general health whilst on the treatment.

People taking Skyrizi are more at risk of infections and so should be vaccinated against pneumonia and have an annual flu vaccination. However, not all vaccinations are safe in people taking Skyrizi and ‘live’ vaccinations (for example yellow fever, shingles) should not be given whilst on Skyrizi and for one year after stopping Skyrizi. Check with a doctor, nurse or pharmacist before having any vaccinations or taking other medication if you are not sure.

For more information on Skyrizi, have a read of our information sheet.