J Dermatol. 2026 Nov 1. doi: 10.1111/1346-8138.70560. Online ahead of print.
ABSTRACT
Vunakizumab is a humanized anti-IL-17A monoclonal antibody approved in China for moderate-to-severe plaque psoriasis. Real-world data on its effectiveness and predictors of response remain scarce. This prospective, single-center, observational study enrolled 34 adults receiving vunakizumab (240 mg subcutaneously at weeks 0, 2, and 4, then every 4 weeks). PASI, PGA, BSA, and DLQI were assessed at baseline and weeks 2, 4, 8, and 12. Univariate logistic regression with Benjamini-Hochberg correction screened baseline predictors of week-4 PASI 90 and week-12 PASI 100. A separate stratification analysis compared week-12 PASI 100 rates between BMI groups using the Chinese-specific threshold of 24 kg/m2 (Fisher exact test). All 34 patients completed the 12-week follow-up (79.4% male; median age 37.5 years; median baseline PASI 10.0). At week 12, PASI 75, PASI 90, and PASI 100 rates were 100%, 91.2%, and 64.7%, respectively, and PGA 0/1 was 100%. Median DLQI decreased from 6.0 at baseline to 0 at week 12 (p < 0.001). Adverse events occurred in 17.6% of patients, all Grade 1. In exploratory analysis, higher BMI was associated with lower week-4 PASI 90 rates (q = 0.032), though the association with week-12 PASI 100 rates did not survive Benjamini-Hochberg correction (q = 0.450). On BMI stratification, normal-weight patients had higher week-12 PASI 100 rates than overweight or obese patients (92.9% vs. 45.0%, p = 0.009). Vunakizumab achieved high PASI 90 and PASI 100 response rates at week 12, with adverse events limited to Grade 1. In this small exploratory cohort, higher BMI was associated with a lower probability of PASI 100 at week 12. Whether this association is reproducible and, if so, whether it should inform patient selection requires prospective evaluation in larger cohorts.
PMID:42968219 | DOI:10.1111/1346-8138.70560