Study Highlights Real-World Experiences of Psoriasis Patients with Bimekizumab

Bimekizumab may be considered effective in improving psoriasis conditions, according to a new case series, with the results including hard-to-treat regions and quality of life improvements.¹

These findings represented the conclusion of recent research assessing bimekizumab’s impact on individuals facing moderate-to-severe chronic plaque psoriasis, specifically looking into real world clinical experience. The findings were drawn from a district general hospital setting in the UK.

This research was led by Omowunmi Ashaolu, from the department of dermatology at Princess of Wales Hospital in Bridgend, UK. Ashaolu acknowledged that psoriasis therapy had been improved substantially following the development of targeted treatments, noting the limited information on real-world experiences of patients.²

“Bimekizumab has demonstrated efficacy and a good safety profile in phase III clinical trials,3 but data from real-world clinical experience remains limited,” Ashaolu et al. wrote. “The aim of this study was to evaluate our experience of bimekizumab as a treatment option for patients with moderate to severe chronic plaque psoriasis in a district general hospital setting.”¹

Background

The investigators noted the advent of targeted biologic therapies as mentioned above, highlighting the promise of monoclonal antibodies which are designed to target interleukin (IL)-17RA (brodalumab) and IL-17A (secukinumab and ixekizumab). They explained the background of bimekizumab, a monoclonal IgG1 antibody which can inhibits IL-17A and IL-17F.

The research team noted the prior approval bimekizumab received from the National Institute for Health and Care Excellence in 2021, specifically indicated for adult patients with moderate to severe plaque psoriasis and a lack of response to standard therapies. The drug was approved by the US Food and Drug Administration (FDA) in 2023 for moderate-to-severe psoriasis patients who are adult and eligible for systemic or phototherapy.³

The FDA’s indication was granted to pharmaceutical company UCB, providing another biologic option for patients which is also a novel inflammation pathway-targeting treatment. The drug was the first dual inhibitor of IL-17A and 17F in this population.

The BE VIVID, BE READY, and BE SURE phase 3 trial data had led to the FDA’s approval of the drug. These were a set of randomized, multicenter, placebo and/or active compactor-controlled trials evaluating the drug among 1480 adults with this condition.

Trial Design and Findings

The new study aimed to evaluate experiences with the drug, bimekizumab, for moderate-to-severe chronic plaque psoriasis within a district general hospital setting. The research team retrospectively collected their data from January - October 2022, with a total of 9 patients, and noted the participation of 2 males, 7 females, and with a mean age of 56.7 years.¹

The investigators observed scalp psoriasis among 5 subjects, with a single participant having palmoplantar psoriasis and 6 having psoriatic arthritis (PsA). There had been 8 identified by the team who reported cardiovascular disease.

The research team added that at the point of baseline, there had been 3 subjects had a Psoriasis Area Severity Index (PASI) score which was more than 10 (median PASI 8.15, range 5.1–17). They added that 6 subjects showed a score on the Dermatology Life Quality Index (DLQI) which was over 10 (median DLQI 16.5, range 5–28), though they added that a single participant’s PASI and DLQI had not been recorded prior to treatment.

One systemic therapy at least was reported, with 7 having had oral methotrexate and 5 with apremilast. The team also found any others would have had at least a single biologic, with 6 specifically having an IL-17A inhibitor, 8 with an IL-23 inhibitor, and 2 with an IL-12/23 inhibitor.

Bimekizumab was introduced by the investigators following an average of 2.8 ± 1.4 prior biologics diminished in their effectiveness over a mean period of 7.2 ± 2.0 years. Prior biologic therapies were discontinued by the team due to loss of efficacy.

Following a 16-week bimekizumab course, all subjects were able to improve to PASI 75 (median PASI 0, range 0–6.4), as well as a DLQI score of at least 5 points to below 10 (median DLQI 0, range 0–4). The research team noted that palmoplantar psoriasis, scalp psoriasis, and joint symptoms also had improved,with a lack of adverse effects.

“Bimekizumab appears to be effective in clearing psoriasis including hard-to-treat sites with improvement in the quality of life,” the investigators concluded. “This case series was limited by small patient numbers, and more real-world experience using bimekizumab is needed.”

References

1. ^{Ashaolu O, Smith T, Askins A, Rajan S, Li V, Kamath S, et al. Bimekizumab as treatment for moderate to severe chronic plaque psoriasis: real world clinical experience from a district general hospital setting. Skin Health Dis. 2024;e418. https://doi.org/10.1002/ski2.418.}
2. ^{Conrad C, Gilliet M. Psoriasis: from pathogenesis to targeted therapies. Clin Rev Allergy Immunol. 2018; 54(1): 102–113. https://doi.org/10.1007/s12016-018-8668-1.}
3. ^{Kunzmann K. FDA Approves Bimekizumab for Adults with Plaque Psoriasis. HCPLive. October 18, 2023. https://www.hcplive.com/view/fda-approves-bimekizumab-adults-plaque-psoriasis. Date accessed: June 29, 2024.}