Bimekizumab in psoriasis: Up-and-coming

In the multicentre, randomised phase 3 BE VIVID trial, bimekizumab led to higher rates of psoriasis improvement compared with ustekinumab in the treatment of moderate-to-severe plaque psoriasis. These results were consistent across subgroups stratified by weight, baseline PASI, and prior biologic therapy.

The novel antibody bimekizumab inhibits IL-17A and IL-17F [1]. “IL-17A and IL-17F are key drivers in the pathogenesis of psoriasis,” Prof. Bruce Strober (Yale University, USA) pointed out. “The response to psoriasis therapy varies based on patient demographics, disease characteristics, and prior treatment exposure. Therapies that provide a consistent and durable response, regardless of these variables are needed.”

The double-blinded, 52-week, phase 3 BE VIVID (NCT03370133) trial was designed to evaluate the efficacy and safety of bimekizumab compared to placebo and ustekinumab for the treatment of moderate-to-severe chronic plaque psoriasis. The 567 adult participants were randomised 4:2:1 to bimekizumab 320 mg (n=321) every 4 weeks, ustekinumab (n=163) in a weight-adjusted dose (45 mg or 90 mg) at baseline, week 4, and subsequently every 12 weeks, or placebo. After 16 weeks, patients in the placebo cohort were switched to bimekizumab. “Just over a third of patients had been previously exposed to biologic therapy,” said Prof. Strober. The current analysis evaluated outcomes for bimekizumab versus ustekinumab only.

At week 16, a Psoriasis Area and Severity Index (PASI) 90 response was achieved by 85.0% of patients with bimekizumab and 49.7% with ustekinumab. At week 52, the corresponding proportions were: 81.9% with bimekizumab and 55.8% with ustekinumab. Looking at differences between weight groups with a cut-off point of 100 kg, results were consistent in both subgroups of bimekizumab with rates over 80% versus around 56% in the ustekinumab groups. Also, stratifying according to PASI <20 or ≥20 led to similar results for achievement of PASI 90. With regard to prior exposure to biologic DMARDs, PASI 90 was achieved by 50.8% in ustekinumab recipients with previous biologics and 59% without history of biologic treatment. For patients treated with bimekizumab, these percentages were 86.6% and 79.1%, respectively.

The secondary endpoint of a PASI 100 response at week 16 was observed in 58.6% of patients treated with bimekizumab and 20.9% with ustekinumab. After 1 year, 64.5% reached PASI 100 with bimekizumab and 38.0% with ustekinumab. Similar to the PASI 90 results, the PASI 100 results were consistent across subgroups stratified by weight, baseline PASI, and prior biologic therapy.

“Bimekizumab demonstrated greater skin clearance that was durable in patients with moderate-to-severe plaque psoriasis as compared with ustekinumab, regardless of patient subgroup,” stressed Prof. Strober. “These results support bimekizumab as a psoriasis treatment suitable for a wide variety of patients given its consistent efficacy across all subgroups analysed.”

 

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   1. Strober B, et al. Bimekizumab versus ustekinumab efficacy across subgroups of patients with moderate to severe plaque psoriasis: Results from the multicentre, randomised, double-blinded phase 3 BE VIVID trial. FC03.06, EADV 2020 Virtual Congress, 29-31 Oct.

 



Posted on 17 December 202018 December 2020