Bimekizumab Shows Sustained Benefits in Psoriasis

TOPLINE:

Continuous treatment with bimekizumab and switching from secukinumab to bimekizumab demonstrate a high clinical response over 3 years in patients with moderate to severe plaque psoriasis. Bimekizumab is well tolerated, and treatment-emergent adverse events (TEAEs) do not increase with prolonged exposure.

METHODOLOGY:

• Researchers conducted a phase 3b trial (BE RADIANT) in which 743 patients were randomly assigned to receive either 320 mg bimekizumab every 4 weeks or 300 mg secukinumab weekly until week 4 and then every 4 weeks.
• Participants receiving bimekizumab underwent rerandomisation in a 1:2 ratio at week 16 to receive a maintenance dose either every 4 or 8 weeks until week 48; those receiving secukinumab at baseline continued the same regimen until week 48.
• This analysis included 336 bimekizumab-treated and 318 secukinumab-treated patients who entered the open-label extension period at week 48, with all patients receiving bimekizumab from week 48 onwards.
• The primary efficacy measures included percentages of patients achieving improvement in Psoriasis Area and Severity Index (PASI) 100, Investigator’s Global Assessment (IGA) 0/1, and Dermatology Life Quality Index (DLQI) 0/1 scores, assessed from baseline to week 144; body surface area ≤ 1% was a key treat-to-target outcome.

TAKEAWAY:

• Overall, 74.9% of bimekizumab-treated patients vs 52.8% of secukinumab-treated patients who entered the open-label extension period achieved PASI 100 at week 48.
• PASI 100 response rates were maintained at 68.8% over 3 years in bimekizumab-treated patients, with those switching from secukinumab to bimekizumab at week 48 achieving comparable rates of 68.8%.
• Rates of achieving body surface area ≤ 1%, IGA 0/1, and DLQI 0/1 were higher at weeks 4 and 48 in bimekizumab-treated patients than in secukinumab-treated patients; however, at 3 years, these rates were comparable for the continuous bimekizumab-treated patients and those switching from secukinumab to bimekizumab at week 48.
• Response rates for all outcomes were maintained until week 144 in the continuous bimekizumab-treated patients, with secukinumab-treated patients achieving comparable rates after switching to bimekizumab.
• Rates of TEAEs, including serious infections, inflammatory bowel disease, and suicidal ideation and behaviour, did not increase with longer exposure to bimekizumab from 1 to 3 years. Rates of serious and severe TEAEs for patients receiving at least one bimekizumab dose did not increase from 1 to 3 years.

IN PRACTICE:

“Complete skin clearance was achieved and maintained by over two-thirds of patients receiving continuous bimekizumab treatment over 3 years. Response rates increased in secukinumab-treated patients upon switching to bimekizumab and were maintained to the end of Year 3,” the authors wrote. “Bimekizumab was well-tolerated over 3 years, and rates of TEAEs did not increase with prolonged bimekizumab exposure,” they added.

SOURCE:

This study was led by Richard B. Warren, Dermatology Centre, Northern Care Alliance NHS Foundation Trust, Manchester, United Kingdom. It was published online on January 25, 2025, in the British Journal of Dermatology. 

LIMITATIONS:

The findings may have limited generalisability to real-world populations due to minimal racial diversity in the study population. Although discontinuation rates were low over 1 year, the analysis included only patients who entered the open-label extension period, potentially introducing selection bias as these patients may have been more responsive to or better tolerated bimekizumab. Additionally, the impact of the COVID-19 pandemic, which overlapped with the open-label extension period and may have introduced confounding factors, may have altered the incidence of AEs.

DISCLOSURES:

This study received funding from UCB and support from the National Institute for Health and Care Research Manchester Biomedical Research Centre. Warren reported receiving consulting fees, research grants to his institution, and honoraria from various pharmaceutical companies. Five authors reported being employees and shareholders of UCB. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.