Enhancing Athletic Performance: Systematic Review and Meta-Analysis of Risankizumab for Athletes with Moderate-to-Severe Psoriasis

Abstract

Background: Risankizumab, a biologic targeting IL-23, has demonstrated promising results in clinical trials for treating moderate-to-severe psoriasis. However, its efficacy and safety in real-world applications, particularly among athletes, remain to be fully explored. Objective: This systematic review and meta-analysis aim to evaluate the real-world effectiveness and safety of risankizumab in athletes with moderate-to-severe psoriasis, with a focus on long-term outcomes. Methods: Following PRISMA guidelines, a comprehensive search was conducted in PubMed, EMBASE, and the Cochrane Library for real-world studies reporting on the efficacy, safety, and rates of drug discontinuation of risankizumab. The primary outcomes were changes in the Psoriasis Area and Severity Index (PASI) scores (PASI 50, PASI 75, PASI 90, and PASI 100). Results: Seventeen studies involving 1109 patients were included. The cumulative percentages achieving PASI 50, PASI 75, PASI 90, and PASI 100 were 96.4%, 80.2%, 57.2%, and 41.7%, respectively. At weeks 16, 28, and 52, the pooled PASI 75 response rates were 85.4%, 92.0%, and 96.2%; PASI 90 rates were 62.6%, 76.2%, and 86.3%; and PASI 100 rates were 42.9%, 56.4%, and 70.3%. The overall incidence of adverse events was low at 4.5%, with most being mild to moderate, including pharyngitis and headaches. The rate of drug discontinuation was also low (3.5%). Conclusion: Risankizumab appears to be a highly effective and safe treatment for athletes with moderate-to-severe psoriasis, supporting its use in this unique population. The drug maintains strong efficacy and safety profiles over the long term, potentially allowing athletes to continue their sports activities with minimal interruption. Further research is recommended to explore specific strategies for integrating this treatment into the holistic management of athlete health.