New Psoriasis Treatments: A Primer

A Novel IL-17A and IL-17F Inhibitor on the Horizon

Bimekizumab is an emerging biologic agent that targets IL-17A and IL-17F isoforms, both of which play an important role in the pathogenesis of psoriasis. Several phase 3 studies have shown highly robust efficacy of bimekizumab.

BE READY, a multicenter, double-blinded, placebo-controlled, phase 3 trial assessed the efficacy and safety of bimekizumab 320 mg compared with placebo (4:1) every 4 weeks for patients with moderate to severe psoriasis. Bimekizumab-treated patients who achieved a PASI 90 response at week 16 were rerandomized (1:1:1) to receive either bimekizumab 320 mg every 4 weeks, bimekizumab 320 mg every 8 weeks, or placebo for weeks 16-56. Patients in both bimekizumab groups had high levels of treatment response, with 91% achieving a PASI 90 response and 93% achieving an Investigator Global Assessment (IGA) score of 0 (clear) or 1 (almost clear); treatment responses were durable in both maintenance dose groups over 56 weeks. Bimekizumab was generally well tolerated; although oral candidiasis was reported in approximately 10% of patients, the vast majority of patients had mild infections that did not necessitate discontinuation of treatment.

In addition to findings from BE READY, three phase 3 trials with active comparators have demonstrated the superiority of bimekizumab over ustekinumab (BE VIVID), adalimumab (BE SURE), and secukinumab (BE RADIANT) in treating plaque psoriasis.

BE VIVID was a 52-week trial wherein patients with moderate to severe psoriasis were randomized to receive bimekizumab 320 mg every 4 weeks; ustekinumab 45 mg or 90 mg (baseline weight-dependent dosing) at weeks 0 and 4, then every 12 weeks; or placebo every 4 weeks (4:2:1). At week 16, bimekizumab-treated patients achieved higher rates of PASI 90 responses compared with ustekinumab-treated patients and placebo-treated patients (85% vs 50% vs 5%).

The BE SURE trial randomized patients with moderate to severe psoriasis to receive bimekizumab 320 mg every 4 weeks for 56 weeks; bimekizumab 320 mg every 4 weeks for 16 weeks, then every 8 weeks for weeks 16 to 56; or adalimumab 40 mg every 2 weeks for 24 weeks, followed by bimekizumab 320 mg every 4 weeks to week 56. At week 56, a little more than 86% of patients treated with bimekizumab achieved a PASI 90 response compared with just over 47% of patients treated with adalimumab.

BE RADIANT was a 48-week trial that randomized patients to receive bimekizumab 320 mg every 4 weeks or secukinumab 300 mg weekly to week 4, followed by every 4 weeks to week 48. At week 48, 67% of patients treated with bimekizumab had a PASI 100 response, compared with a little more than 46% of patients treated with secukinumab. Regarding safety, in the BE SURE and BE RADIANT trials, bimekizumab was associated with higher frequency of mild to moderate oral candidiasis.

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: New Psoriasis Treatments: A Primer - Medscape - Aug 17, 2021.

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