Effectiveness of bimekizumab according to previous biologic exposure in patients with plaque psoriasis

OBJECTIVESBimekizumab, a dual interleukin (IL)-17A/IL-17F inhibitor, has demonstrated clinical efficacy in clinical trials. However, real-world evidence comparing outcomes according to previous biologic exposure remains limited. We evaluated the effectiveness of bimekizumab in biologic-naïve and biologic-experienced patients with plaque psoriasis, including high-impact body areas.

METHODSWe retrospectively analyzed 98 patients treated with bimekizumab (23 biologic-naïve, 75 biologic-experienced). Outcomes included Psoriasis Area and Severity Index (PASI), PASI90 and PASI100 response rates, and Physician Global Assessment (PGA) scores for scalp, nail, genital, palmoplantar, and pretibial psoriasis. Biologic-experienced patients were further stratified by the number of prior biologics.

RESULTSDespite higher baseline PASI values (18.04 vs. 13.29; p = 0.021), biologic-naïve patients achieved significantly faster responses. At week 4, PASI reduction (85.5% vs. 62.5%; p < 0.001), PASI90 (50.0% vs. 13.3%; p = 0.001), and PASI100 (50.0% vs. 11.7%; p = 0.001) were significantly higher in biologic-naïve patients. Similar findings were observed in high-impact areas. Differences persisted through week 16 but disappeared from week 24 onward. Nevertheless, biologic-naïve patients maintained numerically higher response rates throughout follow-up. Previous biologic burden did not compromise long-term outcomes.

CONCLUSIONSBimekizumab showed sustained effectiveness regardless of prior biologic exposure. Nevertheless, biologic-naïve patients achieved faster and deeper responses, supporting earlier use of bimekizumab to maximize treatment benefit.

Abstract from PubMed