Long-Term Bimekizumab Treatment Shown to be Effective for Patients with Psoriasis

Long-term treatment with bimekizumab is highly effective for individuals with moderate-to-severe psoriasis, according to new findings, and key factors such as age may function as predictors for long-term efficacy.¹

These data resulted from a recent study in Japan, authored in part by Teppei Hagino, from the department of dermatology at Nippon Medical School Chiba Hokusoh Hospital. Hagino et al. noted the role played by the interleukin (IL)-23/IL-17 axis in psoriasis, adding that bimekizumab is a novel antibody designed to impact both IL-17A and IL-17F.²

They also highlighted that the predictive elements indicating higher levels of responsiveness to bimekizumab had not yet been well-established in real-world clinical practice settings.

“The aim of this study was to evaluate the effectiveness and safety of long-term (52 weeks) treatment with bimekizumab for psoriasis in real-world practice, and to identify predictive factors for responders to bimekizumab, defined as patients who achieved a Psoriasis Area and Severity Index (PASI) score of 100,” Hagino and colleagues wrote.¹

Background and Design

The research team carried out their retrospective analysis by assessing patients who had been aged 15 years and older and given a diagnosis of moderate-to-severe psoriasis in the period between May 2022 - March 2024. Data necessary for their research were collected retrospectively using medical records.

A regimen of 320 mg of bimekizumab was provided at the start of the treatment period, with the medication administered every 4 weeks until the 16-week mark. After this point, the research team shifted their dosing schedule based on clinical outcomes.

Treatment with bimekizumab had occurred at the Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital. Among the 56 subjects included in the analysis, 24 continued with 320 mg every 4 weeks.

The investigative team noted that 32 transitioned to a new dosing schedule of 320 mg every 8 weeks.

The data collected by the team at baseline included sex, body mass index, age, duration of disease, prior implementation of biologics or apremilast, smoking status, presence of diabetes, and initial scores for the Psoriasis Area and Severity Index (PASI), static Physician's Global Assessment (sPGA), and Dermatology Life Quality Index (DLQI).

Laboratory measures were also assessed by the team, some of which included neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), monocyte-to-lymphocyte ratio (MLR), systemic immuno-inflammatory index (SII), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory response index (SIRI).

These measures were noted by the investigators as being indicators of systemic inflammation. They have previously been analyzed as prognostic markers for conditions such as cardiovascular conditions and psoriasis.

The medication's efficacy was evaluated through assessment of shifts in PASI scores over the course of therapy. They compared baseline characteristics between responders and poor responders. Treatment-emergent adverse events (TEAEs) were also noted by the investigators to assess safety.

Notable Findings

The investigators concluded that by the 52-week mark, 72.4% of those they had assessed in their analysis achieved PASI 100. They added that 94.7% and 93.3% successfully achieved a static PGA 0/1 and DLQI 0/1, respectively.

Short-term responders were found to have lower baseline levels of MLR, NLR, and SIRI as opposed to those known to be poor responders. The research team also found that long-term responders had been younger and maintained lower MLR values.

In terms of TEAEs, the investigators noted them to mild or moderate, adding that there had not been any severe adverse events. Overall, in addition to their findings on the drug's efficacy and safety, the research team highlighted the fact that lower MLR as well as younger age could potentially function as predictors of a positive long-term response.

“In conclusion, this real-world study showed that long-term treatment with bimekizumab was highly effective for patients with moderate-to-severe psoriasis, with a 72.4% PASI 100 achievement at week 52,” they wrote.¹

References

1. ^{Hagino T, Saeki H, Fujimoto E, Kanda N. Effectiveness of long-term bimekizumab treatment and predictive factors for responders in moderate-to-severe psoriasis: A 52-week real-world study. J Dermatol. 2024; 00: 1–12. https://doi.org/10.1111/1346-8138.17532.}
2. ^{Ten Bergen LL, Petrovic A, Krogh Aarebrot A, Appel S. The TNF/IL-23/IL-17 axis-head-to-head trials comparing different biologics in psoriasis treatment. Scand J Immunol. 2020; 92:e12946.}