Mark Lebwohl, MD: Implications of 4 Year Data on Bimekizumab for Psoriasis Treatment

During this segment of his interview with the HCPLive editorial team at the American Academy of Dermatology (AAD) conference, Mark Lebwohl, MD, further discussed his team’s new 4-year data on moderate-to-severe plaque psoriasis treated with bimekizumab-bkzx (Bimzelx).

As highlighted in a previous article, Lebwohl’s team identified that patients with psoriasis showed high clinical and health-related quality-of-life rates of response through 4 years of bimekizumab treatment, with around 6 out of 10 patients treated reporting complete skin clearance by the 4-year mark.

Lebwohl was first asked to express any potential implications that his team’s findings have for clinical practice, particularly in terms of treatment selection and management strategies.

“(There are) a couple of impacts,” Lebwohl explained. “First of all, if patients are not doing well enough on their current therapy of psoriasis, systemic therapy or biologic therapy, we now have an agent that works better than everything else we have in terms of PASI scores. So it would be very logical to move to this drug. Probably safer than combining treatments, which is often something we've been doing lately to make patients better.”

Lebwohl further described the impact of the new 4-year findings in the field of dermatology.

“The second point is that the drug is so effective that you have to ask the question: When we start patients on a new treatment, why not this one?” he said. “And I will say, there is an answer to that, which is that I think many patients should start on this one. If somebody, for example, has to clear very quickly because an important event is coming up, this is the fastest drug we have. There are many other reasons to choose this one first line.”

Lebwohl added, however, that the only reason not to make such a move is the rate of Monilial infections.

“Specifically, thrush is as many as 1 in 5 patients,” Lebwohl said. “Whereas with the other IL-17 blockers, that number is closer to 1 in 20, so for that you do pay a little bit of a price. Now the Monilial infections are mild, so they're easy to treat, and respond quickly to fluconazole or whatever treatment you pick. So it's not a big drawback, but it is a drawback which can be considered if patients are starting on a new drug.”

Lebwohl later added that he hopes that bimekizumab receives a US Food and Drug Administration (FDA) approval in the future for psoriatic arthritis. He noted that there are many more areas for exploration that he hopes are evaluated.

To learn more about the long-term results and their implications, view the full interview segment.

The quotes contained in this article were edited for the purposes of clarity.