AbstractBackgroundPsoriasis is an inflammatory skin disease that impacts a heterogeneous group of patients and can have multiple clinical manifestations. Risankizumab is approved for the treatment of moderate‐to‐severe plaque psoriasis.ObjectivesTo evaluate the long‐term efficacy of risankizumab according to baseline patient characteristics, and for the treatment of high‐impact disease manifestations (nail, scalp and palmoplantar psoriasis), through 256 weeks of continuous treatment in the phase 3 LIMMitless study.MethodsThis subgroup analysis evaluated pooled data from patients with moderate‐to‐severe plaque psoriasis who were randomized to risankizumab 150 mg during two double‐blind, phase 3, 52‐week base studies (UltIMMa‐1/2; NCT02684370/NCT02684357) and were enrolled in the phase 3 LIMMitless open‐label extension study (NCT03047395). Subgroup assessments included the proportion of patients who achieved ≥90%/100% improvement in Psoriasis Area and Severity Index (PASI 90/100). Among patients with nail, scalp and/or palmoplantar psoriasis in addition to skin psoriasis, assessments included changes from baseline in and resolution of these three psoriatic manifestations.ResultsOverall, a numerically similar proportion of patients (N = 525) achieved PASI 90/100 through Week 256, regardless of their baseline age, sex, body mass index, weight, PASI or psoriatic arthritis status. Patients with nail, scalp and/or palmoplantar psoriasis experienced substantial improvements in manifestation‐specific indices (mean improvement from baseline to Week 256 of >81%, >94% and >97%, respectively); in patients with all three manifestations (N = 121), 44.6% achieved complete clearance of these manifestations at Week 256.ConclusionsRisankizumab demonstrated generally consistent efficacy through 256 weeks across patient subgroups and showed durable long‐term efficacy for psoriatic disease manifestations.