Strengths, Limitations of IL-17 A/F Inhibition in Hidradenitis Suppurativa

EP: 1.Examining Treatment Landscape, Options in Hidradenitis Suppurativa

EP: 2.Understanding, Leveraging IL-17 A/F Inhibition with Bimekizumab in HS

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EP: 3.Strengths, Limitations of IL-17 A/F Inhibition in Hidradenitis Suppurativa

EP: 4.Safety Profile of Bimekizumab in Hidradenitis Suppurativa

EP: 5.Future Research, Opportunities in Hidradenitis Suppurativa

In this segment of our 5-part video series, Martina Porter, MD, a dermatologist at Beth Israel Deaconess Medical Center, and Colleen Cotton, MD, a dermatologist with National Children's Hospital, explore the advantages and limitations of using bimekizumab as an alternative therapy for patients with hidradenitis suppurativa (HS) who fail or lose response to other biologics. Their discussion highlights the clinical promise of this newly approved treatment while acknowledging practical and patient-specific challenges.

Cotton emphasizes that one of the key advantages of bimekizumab is simply its availability, offering patients a novel mechanism of action with dual inhibition of IL-17A and IL-17F. This differentiates it from existing options, such as TNF-alpha inhibitors, and may renew hope for patients who have not responded to previous therapies. However, she points out that significant limitations remain, particularly for pediatric patients under 18. Insurance barriers make it exceedingly difficult to secure off-label coverage, even in cases with supportive safety data.

Cotton also raises concerns regarding the potential overlap of HS and inflammatory bowel disease (IBD), such as Crohn’s disease and ulcerative colitis. Because IL-17 inhibitors can exacerbate IBD, bimekizumab is not a suitable option for patients with active IBD who have failed other biologics. This underscores the need for a nuanced approach to treatment selection based on individual patient profiles.

Porter concurs, recognizing that while bimekizumab expands the therapeutic landscape for HS, careful consideration of patient-specific factors, such as age and comorbidities, remains essential.

Relevant disclosures for Porter include Abbvie, Bristol Myers Squibb, Janssen, Eli Lilly, Novartis, Pfizer, UCB, Trifecta Clinical, Incyte, and Anaptys Bio. Relevant disclosures for Cotton include Leo Pharma, Novartis, Avita Medical, and others.