Dual IL-17A and IL-17F blocker leads to unprecedented response rates in psoriasis

Data from a randomised extension study showed that patients with moderate-to-severe plaque psoriasis attained durable complete and near-complete responses for more than a year with a dual inhibitor of IL-17 [1].

Both IL-17A and IL-17F are expressed in psoriasis lesional skin and have the ability to synergise with other cytokines to amplify inflammation. This is the pathogenetic rationale to block IL-17F in addition to IL-17A. Bimekizumab is an antibody that neutralises the biologic function of both.

In the original 12-week BE ABLE 1 study previously presented, therapy with bimekizumab led to rapid, substantial clinical improvements in patients with moderate-to-severe plaque psoriasis [2]. More than 70% of patients treated with 160, 320, or 480 mg bimekizumab reached an improvement of the PASI by 90% (PASI90 response) in this trial. At this year´s AAD meeting, results were presented of the phase 2b extension study BE ABLE 2 after 60 weeks of follow-up [6]. In this extension, almost all patients who initially had PASI90/100 with bimekizumab maintained the responses during 60 weeks of follow-up. Similarly, patients who switched from placebo to bimekizumab and attained PASI90/100 responses maintained the status long-term. Across all doses evaluated in the study, 80-100% of responding patients remained in response at 60 weeks. "We have not seen responses like this," said Dr Andrew Blauvelt (Oregon Medical Research Center, USA). "In addition, we have a consistent safety profile, as would be expected with an IL-17 blocker. These results really support the view that IL-17A and IL-17F blockade is useful in psoriasis."

The most frequent treatment-emergent adverse events were oral candidiasis and nasopharyngitis (13% each). All cases of oral candidiasis were localised, superficial infections of mild or moderate intensity that resolved with standard treatment. No serious treatment-emergent adverse events occurred in more than one patient. These results validate dual neutralisation of IL-17A and IL-17F as a new therapeutic approach, which might result in slightly improved efficacy compared with IL-17A blockade alone.

1. Blauvelt A. Abstract 11180, AAD Annual Meeting, 1-5 March 2019, Washington DC, USA.
2. Papp K, et al. J Am Acad Dermatol 2018; 79:279-86.



Posted on 19 April, 201916 March, 2021