The IL-23 inhibitor from AbbVie indicated for the treatment of adults with
active psoriatic arthritis (PsA) and for moderate to severe plaque psoriasis (Ps)
in adults who are candidates for systemic therapy or phototherapy.¹

IDENTIFYING BIO-NAïVE
PATIENTS WITH PsA

WHO MAY BE READY TO START
ON SKYRIZI

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TITLE CARD:

Nothing is Everything

Nothing less than the opportunity to reach for their treatment goals. For your patients, that’s everything.

Dr. Sergio Schwartzman, MD:

Hello. My name is Dr Sergio Schwartzman. I’ve been a rheumatologist for 35 years, long enough to have a daughter who’s currently a rheumatologist. During those 35 years, I have worked in academics and currently I am in a private practice.

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Dr. Saakshi Khattri, MD:

My name is Dr. Saakshi Khattri and I am a board certified dermatologist, rheumatologist and internist working in the department of dermatology at the Icahn School of Medicine at Mount Sinai. Thank you so much for having me today.

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Dr. Sergio Schwartzman, MD:

As rheumatologists, our main treatment goal is the same as our patients’—to achieve relief from the symptoms of psoriatic arthritis.

Making treatment decisions for individual patients with psoriatic arthritis can be challenging due to the heterogeneity of clinical characteristics and the simultaneous involvement of different domains, often with varying degrees of severity.

So let’s begin by discussing how these patients can present in clinical practice and then talk about the type of patient who may be a candidate for a biologic.

Dr. Saakshi Khattri, MD:

Sounds good, Doctor Schwartzman.

To better inform decisions around treatment selection, it is important to identify where in their disease progression a patient may be and assess their level of disease activity.

Some patients come to me and need a biologic from the start. However, if a patient is on standard therapy and still has residual swollen and/or tender joints, reports pain and morning stiffness, and also has some level of skin involvement, then I’d typically sit down with them and discuss starting on a biologic.

Dr. Sergio Schwartzman, MD:

Before I sit down with my patients, I often refer back to clinical guidelines.

And interestingly, 2021 GRAPPA treatment recommendations are a domain-based strategy for psoriatic arthritis.

As a member of GRAPPA, we use a systematic literature search and grading system to update treatment recommendations.

These treatment recommendations provide up-to-date evidence-based guidance to providers who manage and treat patients with psoriatic arthritis.

The domain-based strategy considers all 6 domains of psoriatic arthritis. These domains include peripheral arthritis, axial arthritis, enthesitis, dactylitis, skin, and nail disease. For example, if a clinician were looking for a treatment option for a patient presenting with psoriasis, peripheral arthritis, enthesitis, and dactylitis, GRAPPA strongly recommends interleukin 23 inhibitors as treatment options for first-line therapy just like TNF and interleukin 17 inhibitors.

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Dr. Saakshi Khattri, MD:

Agreed, the GRAPPA guidelines are one of the factors contributing to my treatment decision. As a clinician, it is my job to consider the individualized treatment goals for each patient to inform the optimal treatment choice for them. It is important to know that we, as treating rheumatologists, have another option like the IL-23 class you mentioned as a patient transitions from conventional therapy like methotrexate.

Dr. Sergio Schwartzman, MD:

Since you brought that up, let’s discuss an IL-23 inhibitor, specifically SKYRIZI, that was studied as a first-line biologic therapy in bio-naïve adults with active PsA.

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VO:

Please see Important Safety Information at the end of this video and review the Full Prescribing Information at the link onscreen or on the website at SKYRIZIhcp.com.

VO:

SKYRIZI is indicated for the treatment of active psoriatic arthritis in adults and for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy.

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VO TALENT:

SKYRIZI is contraindicated in patients with a history of serious hypersensitivity reactions to risankizumab or any of its excipients. Serious hypersensitivity reactions may occur and also an increased risk of infection. Instruct patients to report signs and symptoms of infection. Evaluate patients for TB infection prior to initiating treatment. Avoid use of live vaccines.

Dr. Sergio Schwartzman, MD:

Let’s get into the trial!

Dr. Sergio Schwartzman, MD:

As I mentioned, KEEPsAKE-1 was a study in bio-naïve adults with active psoriatic arthritis. The eligibility criteria included patients who had symptom onset for at least 6 months and had at least 5 tender and 5 swollen joints among other criteria.

All of the patients enrolled had experienced an inadequate response, intolerance, or contraindication to at least 1 DMARD; however, they had no prior exposure to biologics.

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Dr. Sergio Schwartzman, MD:

It is important to keep in mind that when looking at clinical trials, we often see baseline characteristics that are somewhat different than what we usually see in clinical practice.

But tell me what stands out to you about the baseline characteristics of these patients.

Dr. Saakshi Khattri, MD:

Well, these patients’ baseline characteristics seem higher than the typical bio-naïve patient I might see in my practice, especially in regards to the number of swollen and tender joints.

We can see that these patients had a mean disease duration just over 7 years and had active joint and skin disease. In this study at baseline, patients had a mean count of 12 swollen and 21 tender joints, which is much higher than the typical bio-naive patient I see in my clinical practice. Average body surface area was over 16% and enthesitis was reported in over 60% of patients and dactylitis in over 30%.

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Dr. Sergio Schwartzman, MD:

I would agree. Even though these patients were previously treated with conventional therapy, like methotrexate, the baseline characteristics shown represent patients with disease that involved multiple domains.

Dr. Saakshi Khattri, MD:

This helps put into perspective the results I might expect to see with SKYRIZI in my bio-naïve patients.

In addition to questions about efficacy, oftentimes in the discussions I have with my patients, questions about safety come up as well. Some of my patients also ask about dosing and administration.

Dr. Saakshi Khattri, MD:

For adult patients with active psoriatic arthritis, clinical trials showed that SKYRIZI provided joint symptom improvement and skin clearance.

We also know that SKYRIZI’s safety profile has been established in psoriatic arthritis and psoriasis across 19 trials—2 in psoriatic arthritis and 17 in psoriasis. That translates to over 11,000 patient-years of exposure across indications.

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Dr. Sergio Schwartzman, MD:

Since you brought up dosing, some patients appreciate the reliable quarterly dosing, after 2 initiation doses at Weeks 0 and 4.

It is nice to know when considering a treatment that SKYRIZI has exceptional formulary access with over 95% of national commercial and Medicare Part D patients having preferred coverage.

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Dr. Saakshi Khattri, MD:

It’s always good to have a vast arsenal of different treatment options to choose from. However, I think it’s critical for us as clinicians to understand the nuances of the therapies we’re using and recognize how they may apply to the patient we are treating.

Patients may have questions about efficacy and safety, and we should take into account how these specific variables may be applicable to them as we work together to determine the best treatment option for individual patients.

Dr. Sergio Schwartzman, MD:

I agree. And as we’ve seen, SKYRIZI, the #1 prescribed biologic in new and switching patients with psoriasis, may be an option for adult patients with active psoriatic arthritis presenting earlier in their disease progression, including for those who have not had experience with a prior biologic.

VO Talent:

Important Safety Information

Hypersensitivity Reactions

SKYRIZI® (risankizumab-rzaa) is contraindicated in patients with a history of serious hypersensitivity reaction to risankizumab-rzaa or any of the excipients. Serious hypersensitivity reactions, including anaphylaxis, have been reported with the use of SKYRIZI. If a serious hypersensitivity reaction occurs, discontinue SKYRIZI and initiate appropriate therapy immediately.

Infection

SKYRIZI may increase the risk of infection. Do not initiate treatment with SKYRIZI in patients with a clinically important active infection until it resolves or is adequately treated. In patients with a chronic infection or a history of recurrent infection, consider the risks and benefits prior to prescribing SKYRIZI. Instruct patients to seek medical advice if signs or symptoms of clinically important infection occur. If a patient develops such an infection or is not responding to standard therapy, closely monitor and discontinue SKYRIZI until the infection resolves.

Tuberculosis (TB)

Prior to initiating treatment with SKYRIZI, evaluate for TB infection and consider treatment in patients with latent or active TB for whom an adequate course of treatment cannot be confirmed. Monitor patients for signs and symptoms of active TB during and after SKYRIZI treatment. Do not administer SKYRIZI to patients with active TB.

VO Talent:

Administration of Vaccines

Avoid use of live vaccines in patients treated with SKYRIZI. Medications that interact with the immune system may increase the risk of infection following administration of live vaccines. Prior to initiating SKYRIZI, complete all age appropriate vaccinations according to current immunization guidelines.

Adverse Reactions

Most common (≥1%) adverse reactions associated with SKYRIZI include upper respiratory infections, headache, fatigue, injection site reactions, and tinea infections.

In psoriatic arthritis phase 3 trials, the incidence of hepatic events was higher with SKYRIZI compared to placebo.

SKYRIZI is available in a 150 mg/mL prefilled syringe and pen.

Please see Full Prescribing Information available at the link onscreen.

References

[SKYRIZI and AbbVie logos]

US-SKZR-220080

ARE YOUR BIO-NAÏVE PATIENTS READY FOR SKYRIZI?

Clinical experts Dr. Schwartzman and Dr. Khattri explore the KEEPsAKE 1 PsA trial and how to determine when a bio-naïve patient might be ready to start on SKYRIZI, as well as other topics, including:

GRAPPA recommendations of treatments for PsA include IL-23 inhibitors just like TNF and IL-17 inhibitors
Overview of bio-naïve patients enrolled in KEEPsAKE 1 PsA trial

MEET THE KEY OPINION LEADERS

SERGIO SCHWARTZMAN, MD

Dr. Schwartzman completed an internship and residency in internal medicine at Long Island Jewish Medical Center in New Hyde Park, New York, and fellowships in the Division of Rheumatic Diseases at New York Hospital and the Hospital for Special Surgery.

Dr. Schwartzman is a member of the American College of Rheumatology, the Spondyloarthritis Research & Treatment Network, the American Uveitis Society, and the Group for Research and Assessment of Psoriasis. He is the Franchellie M. Cadwell Emeritus chair at the Hospital for Special Surgery, Associate Attending Physician at the New York Presbyterian Hospital, and Associate Professor Medicine at Weill Cornell Medical Center.

He is currently in private practice in New York City and has over 34 years of experience and focus in the areas of PsA, RA, AS, autoimmune eye disease, and IBD-associated arthritis.

SAAKSHI KHATTRI, MD

Dr. Saakshi Khattri is a board-certified rheumatologist, dermatologist, and internist and one of only a handful of triple-board-certified physicians across the United States.

After completing her MBBS from Delhi University, Dr. Khattri moved to New York to complete her internal medicine residency followed by a fellowship in rheumatology at the Albert Einstein College of Medicine in New York. She completed a 2-year research fellowship at Rockefeller University where she conducted research and ran clinical trials in atopic dermatitis and psoriasis under the mentorship of Dr. Emma Guttman and Dr. James Krueger.

Dr. Khattri then successfully completed a residency in dermatology at the Icahn School of Medicine at Mount Sinai.

ACR20/50/70 RESPONSE RATES

In patients with PsA at Week 24 and ~3 years^1-3

Primary endpoint ACR20 at 24 weeks¹

View the results in joints

WELL-STUDIED SAFETY PROFILE

Across PsA & Ps¹

Review the safety profile

IDENTIFYING BIO-NAïVE
PATIENTS WITH PsA

WHO MAY BE READY TO START
ON SKYRIZI

ARE YOUR BIO-NAÏVE PATIENTS READY FOR SKYRIZI?

MEET THE KEY OPINION LEADERS

SERGIO SCHWARTZMAN, MD

SAAKSHI KHATTRI, MD

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

Indications

STUDY DESIGN—KEEPsAKE 1 AND KEEPsAKE 2^1-7

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

Indications

IDENTIFYING BIO-NAïVE PATIENTS WITH PsA

WHO MAY BE READY TO START ON SKYRIZI

ARE YOUR BIO-NAÏVE PATIENTS READY FOR SKYRIZI?

MEET THE KEY OPINION LEADERS

SERGIO SCHWARTZMAN, MD

SAAKSHI KHATTRI, MD

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)1

Indications

STUDY DESIGN–IMMvent1

SELECTED BASELINE CHARACTERISTICS1,2

STUDY DESIGN–IMMerge1

SELECTED BASELINE CHARACTERISTICS1

STUDY DESIGN—IMMhance1,2

SELECTED BASELINE CHARACTERISTICS1,2

STUDY DESIGN–UltIMMa-1 and UltIMMa-2 LIMMitless OLE1-5

SELECTED BASELINE CHARACTERISTICS1

STUDY DESIGN–UltIMMa-1 and UltIMMa-21,2

SELECTED BASELINE CHARACTERISTICS1

STUDY DESIGN–UltIMMa-1 and UltIMMa-21,2

SELECTED BASELINE CHARACTERISTICS1

STUDY DESIGN—KEEPsAKE 1 and KEEPsAKE 21-5

SELECTED BASELINE CHARACTERISTICS IN PsA CLINICAL TRIALS1,2

STUDY DESIGN—KEEPsAKE 1 AND KEEPsAKE 21-7

SELECTED BASELINE CHARACTERISTICS1,2

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)1

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)1

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)1

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)1

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)1

Indications

IDENTIFYING BIO-NAïVE
PATIENTS WITH PsA

WHO MAY BE READY TO START
ON SKYRIZI

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

STUDY DESIGN–IMMvent¹

SELECTED BASELINE CHARACTERISTICS^1,2

STUDY DESIGN–IMMerge¹

SELECTED BASELINE CHARACTERISTICS¹

STUDY DESIGN—IMMhance^1,2

SELECTED BASELINE CHARACTERISTICS^1,2

STUDY DESIGN–UltIMMa-1 and UltIMMa-2 LIMMitless OLE^1-5

SELECTED BASELINE CHARACTERISTICS¹

STUDY DESIGN–UltIMMa-1 and UltIMMa-2^1,2

SELECTED BASELINE CHARACTERISTICS¹

STUDY DESIGN–UltIMMa-1 and UltIMMa-2^1,2

SELECTED BASELINE CHARACTERISTICS¹

STUDY DESIGN—KEEPsAKE 1 and KEEPsAKE 2^1-5

SELECTED BASELINE CHARACTERISTICS IN PsA CLINICAL TRIALS^1,2

STUDY DESIGN—KEEPsAKE 1 AND KEEPsAKE 2^1-7

SELECTED BASELINE CHARACTERISTICS^1,2

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹

IMPORTANT SAFETY INFORMATION AND INDICATIONS FOR SKYRIZI® (risankizumab-rzaa)¹