bimekizumab for treating moderate to severe plaque psoriasis

Last edited 10/2023 and last reviewed 10/2023

Bimekizumab for treating moderate to severe plaque psoriasis

NICE guidance states (1):

Bimekizumab is recommended as an option for treating plaque psoriasis in adults, only if:

• the disease is severe, as defined by a total Psoriasis Area and Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10 and
• the disease has not responded to other systemic treatments, including ciclosporin, methotrexate and phototherapy, or these options are contraindicated or not tolerated

Stop bimekizumab treatment at 16 weeks if the psoriasis has not responded adequately. An adequate response is defined as:

• a 75% reduction in the PASI score (PASI 75) from when treatment started or
• a 50% reduction in the PASI score (PASI 50) and a 5-point reduction in DLQI from when treatment started

Notes

• bimekizumab is a humanized monoclonal IgG1 antibody
  • mechanism of action (dual inhibition of IL-17A and IL-17F) (2,3)
    • selectively neutralizes both IL-17A and IL-17F
    • along with IL-17A, IL-17F can also cooperate with tumor necrosis factor-alpha (TNF-alpha) in inducing the production of key pro-inflammatory keratinocyte mediators (3)
    • mechanism of action allows a more extensive suppression of disease inflammation, with a greater reduction of gene expression, migration of inflammatory cells and production of proinflammatory cytokines than the isolated blockade of IL-17A (2)
    • bimekizumab has no activity on IL-17E (thought to have anti-inflammatory properties), unlike the IL-17RA inhibitor brodalumab (2)
  • is considered a new therapeutic approach for the treatment of moderate-to-severe psoriasis (2)
  • bimekizumab has demonstrated superiority in all direct comparative clinical trials conducted, whether against ustekinumab (IL-12/23 inhibitor), adalimumab (TNF inhibitor) or secukinumab (IL-17A inhibitor), for the treatment of psoriatic arthritis (2)

Reference:

• NICE (September 2021). Bimekizumab for treating moderate to severe plaque psoriasis
• Freitas E, Torres T. Bimekizumab: the new drug in the biologics armamentarium for psoriasis. Drugs Context. 2021;10:2021-4-1.
• Chiricozzi A, De Simone C, Fossati B, Peris K. Emerging treatment options for the treatment of moderate to severe plaque psoriasis and psoriatic arthritis: evaluating bimekizumab and its therapeutic potential [published correction appears in Psoriasis (Auckl). 2019 Aug 15;9:73-74]