To investigate bimekizumab efficacy in scalp, nail and palmoplantar psoriasis.
In this analysis, data are included from the BE SURE, BE VIVID, BE READY, and BE RADIANT phase 3/3b trials (48-56 weeks) and BE BRIGHT open-label extension (144 weeks). Adults with moderate to severe plaque psoriasis and scalp/palmoplantar Investigator's Global Assessment (IGA) score ≥3 or modified Nail Psoriasis Severity Index (mNAPSI) >10 at baseline were randomized to bimekizumab or comparators (adalimumab, ustekinumab, secukinumab, placebo). Higher rates of complete clearance of scalp and palmoplantar psoriasis were generally observed at Week 4 with bimekizumab than comparators.
At Week 24, rates of complete resolution of scalp/nail/palmoplantar psoriasis were 77.7%/39.8%/78.7% with bimekizumab and 58.1%/24.5%/73.3% with adalimumab; at Week 52, 71.9%/54.0%/85.2% with bimekizumab and 51.8%/30.6%/75.0% with ustekinumab; and at Week 48, 80.6%/69.5%/82.4% with bimekizumab and 71.6%/52.5%/76.8% with secukinumab. Complete scalp/nail/palmoplantar clearance rates were sustained through 4 years' bimekizumab treatment (79.5%/61.6%/88.7%). Bimekizumab consistently showed higher rates of complete clearance of psoriasis in high-impact areas along with greater patient-reported health-related quality of life benefits than comparators. Responses were sustained over 4 years, which may lead to improvements in patients' quality of life.
Trial registration: BE SURE (NCT03412747), BE VIVID (NCT03370133), BE RADIANT (NCT03536884), BE READY (NCT03410992), BE BRIGHT (NCT03598790).
Keywords: Biologic treatment; high-impact areas; nail psoriasis; psoriasis; quality of life; scalp psoriasis.
A study to explore how well bimekizumab works to treat psoriasis in ‘high-impact areas’ and whether its effects last over the long termWhat is psoriasis?Psoriasis is a long-lasting condition of the immune system that causes thick, scaly, and often itchy patches on the skin. It often requires life-long treatment and affects approximately 2 in every 100 people worldwide.What are high-impact areas?Psoriasis can be particularly troublesome when it affects the scalp, nails, and the palms and soles, which are known as high-impact areas. Having psoriasis in these areas can negatively affect patients’ daily lives because they are often visible and impact everyday activities. Therefore, achieving clear skin in these areas can greatly improve a person’s quality of life.What did we do?This study used information from clinical trials that took place at hospitals and clinics around the world. We looked at how well a drug called bimekizumab works in clearing psoriasis, specifically in the scalp, nails, palms, and soles. Bimekizumab works by blocking two key proteins involved in the condition. We had two main questions:How well does bimekizumab clear psoriasis in high-impact areas when compared with other treatments that target different proteins involved in psoriasis (adalimumab, ustekinumab, and secukinumab)?Are these effects of bimekizumab treatment maintained over the long term?What did we find?We found that bimekizumab cleared psoriasis well and this effect was maintained long-term in psoriasis in high-impact areas.Comparison with other treatments:Bimekizumab was better at clearing psoriasis in high-impact areas than other common psoriasis treatments, adalimumab, ustekinumab, and secukinumab.More patients treated with bimekizumab who reported clear scalp/nails/palms and soles also reported that their psoriasis was not impacting their quality of life.Long-term results with bimekizumab:Scalp: More than half of patients achieved complete clearance of scalp psoriasis within the first month and this increased to around 8 in 10 people over 4 years.Nail: In around 6 in 10 people, nail psoriasis was completely cleared following 4 years of continuous treatment.Palms and soles: More than half of patients had completely clear skin in the palms and soles after the first month. Responses improved further, and after four years, around 9 in 10 people were clear of psoriasis in these areas.