Real-world Experience of Bimekizumab for Plaque Psoriasis in Adult Patients with Prior Exposure to Interleukin-17 Inhibitors: A 16-week Multicenter Retrospective Review

Siddhartha Sood¹, Alexander Rimke², Brian Rankin³, Abrahim Abduelmula⁴, jorge Georgakopoulos⁴, Khalad Maliyar⁴, Ahmed Bagit⁵, Fernejoy Leung⁶, Alim Devani⁶, Ronald Vender⁷, Jensen Yeung⁴ and Vimal Prajapati³, ¹Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada, ²Dermatology Research Institute, Calgary, AB, Canada, ³Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada, ⁴Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada, ⁵Temerty Faculty of Medicine, University of Toronto, Toronto, Canada, ⁶Skin Health & Wellness Centre, Calgary, AB, Canada, ⁷Division of Dermatology, Department of Medicine, McMaster University, Hamilton, Canada

Meeting: ACR Convergence 2024

Keywords: Biologicals, Dermatology, Psoriatic arthritis

Session Information

Date: Saturday, November 16, 2024

Title: SpA Including PsA – Treatment Poster I

Session Type: Poster Session A

Session Time: 10:30AM-12:30PM

Background/Purpose: While biologic switching is common in routine clinical practice, limited information exists on switching within class from another IL-17i to bimekizumab. We conducted a real-world study of bimekizumab use in the setting of prior IL-17i exposure.

Methods: Our multicenter retrospective review of four institutions in Canada included adult plaque psoriasis patients initiated on bimekizumab following prior exposure to another IL-17i. Effectiveness outcomes, including Investigator Global Assessment (IGA), Psoriasis Area and Severity Index (PASI), body surface area (BSA), and IGAxBSA scores, were measured at week 16±6. Safety was assessed via treatment-related adverse events (AEs).

Results: A total of 43 patients were included; mean age was 44.4 (range: 18-63) years, with 53.5% (23/43) being female. Prior IL-17i agents included secukinumab (62.8%, 27/43), ixekizumab (39.5%, 17/43), and brodalumab (37.2%, 16/43); 32.6% (14/43) utilized ³2 IL-17i agents. Reasons for prior IL-17i discontinuation included inefficacy (88.4%, 38/43), patient preference (7%, 3/43), psoriatic arthritis flare (2.3%, 1/43), and adverse event (AE; 2.3%, 1/43). Primary non-response to prior IL-17i was defined as lack of IGA 0/1 and/or 75% improvement in PASI (PASI75) at week 16, whereas secondary non-response to prior IL-17i was defined as loss of IGA 0/1 and/or PASI75 response at any point afterwards.

At week 16±6: IGA 0/1 was achieved by 96.8% (30/31); mean PASI, BSA, and IGAxBSA improvements from baseline were 94.5% (9.3 to 0.5), 89.2% (8.7% to 0.7%), and 91.4% (24.4 to 1.7), respectively; 97.7% (42/43), 83.7% (36/43), and 62.8% (27/43) achieved PASI75, 90% improvement in PASI (PASI90), and 100% improvement in PASI (PASI100), respectively; 97.7% (42/43), 90.7% (39/43), 79.1% (34/43) achieved absolute PASI scores < 3, < 2, and < 1; and 76.7% (33/43) achieved BSA <1%. In prior IL-17i primary non-responders (n=14), 85.7% (12/14) achieved IGA 0/1 and/or PASI90 and 64.3% (9/14) achieved PASI100 with bimekizumab treatment at week 16±6. In prior IL-17i secondary non-responders (n=15), 93.3% (14/15) achieved IGA 0/1 and/or PASI90 and 73.3% (11/15) achieved PASI100 with bimekizumab treatment at week 16±6. Concomitant systemic therapy was utilized in 14% (6/43) of patients.

Two treatment-related AEs occurred (4.7%, 2/43), both being oral candidiasis; neither led to treatment discontinuation. No serious infections, suicidal ideation/behavior, malignancies, hypersensitivity reactions, major adverse cardiac events, or hepatic abnormalities were observed.

Conclusion: In the BE RADIANT open-label extension study, IGA 0/1, PASI90, and PASI100 responses were 95.7%, 50.9%, and 20.8%, respectively, at week 4 for secukinumab PASI90 non-responders who switched to bimekizumab following a 48-week randomization period. Our results at week 16±6 are comparable for IGA 0/1 (96.8%) and superior for PASI90 (83.7%) and PASI100 (62.8%). Notably, our real-world study included prior IL-17i primary non-responders, while phase III clinical trials excluded this population. Our results highlight the utility of bimekizumab for patients with prior IL-17i exposure. Study limitations include its small sample and retrospective nature.

Disclosures: S. Sood: None; A. Rimke: None; B. Rankin: None; A. Abduelmula: None; j. Georgakopoulos: None; K. Maliyar: None; A. Bagit: None; F. Leung: AbbVie, 1, 2, 6, 12, Investigator, Arcutis, 1, 2, 6, 12, Investigator, Bausch Health, 1, 2, 6, 12, Investigator, BioScript Solutions, 1, 2, 6, 12, Investigator, Incyte, 1, 2, 6, 12, Investigator, Janssen, 1, 2, 6, 12, Investigator, LEO Pharma, 1, 2, 6, 12, Investigator, Novartis, 1, 2, 6, 12, Investigator, UCB, 1, 2, 6, 12, Investigator; A. Devani: AbbVie, Amgen, AnaptysBio, Arcutis, Arena, Bausch Health, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Concert, Dermavant, Dermira, Eli Lilly, 1, 2, 6, 12, Investigator, Galderma, GSK, Incyte, Janssen, LEO Pharma, Medexus, Nimbus Lakshmi, Novartis, Pediapharm, Pfizer, Regeneron, Reistone, Sanofi Genzyme, Sun Pharma,, 1, 2, 6, 12, Investigator, Takeda, Tribute, UCB, and Valeant, 1, 2, 6, 12, Investigator; R. Vender: AbbVie, Actelion, Amgen, Aralez, Arcutis, Astellas, Bausch Health, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Cipher, Centocor, Dermira, 1, 2, 6, 12, Investigator, Dermavant, Eli Lilly, Galderma, GSK, Innovaderm, Janssen, Kabi-Care, LEO Pharma, Merck, Novartis, Palladin, Pfizer, Regeneron, Sandoz, Sun Pharma, 1, 2, 6, 12, Investigator, Takeda, UCB, and Viatris-Mylan, 1, 2, 6, 12, Investigator; J. Yeung: AbbVie, Amgen, Anacor, Arcutis, Astellas, Bausche, Baxalta, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Centocor, Coherus, Dermira, Forward, 1, 2, 6, 12, Investigator, Fresenius Kabi, Galderma, Incyte, Janssen, LEO Pharma, Medimmune, Merck, Novartis, Pfizer, Regeneron, Roche, Sanofi Genzyme, Sun Pharma, Takeda, UCB, 1, 2, 6, 12, Investigator, Xenon, 1, 2, 6, 12, Investigator; V. Prajapati: AbbVie, Actelion, Amgen, Apogee Therapeutics, Aralez, Arcutis, Aspen, Bausch Health/Valeant, BioScript Solutions, Boehringer Ingelheim, 1, 2, 6, AbbVie, AnaptysBio, Arcutis, Arena, Asana, Bausch Health/Valeant, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Concert, CorEvitas, Dermavant,, 12, Investigator, AbbVie, Bausch Health, Janssen, LEO Pharma, Novartis, and Sanofi Genzyme, 5, Bristol Myers Squibb, Canadian Psoriasis Network, Celgene, Cipher, Concert, CorEvitas, Eczema Society of Canada, Eli Lilly, Galderma, GlaxoSmithKline, 1, 2, 6, Dermira, Eli Lilly, Galderma, Incyte, Janssen, LEO Pharma, Meiji Pharma, Nektar Therapeutics, Nimbus Lakshmi, Novartis, Pfizer, Regeneron, 12, Investigator, Homeocan, Incyte, Janssen, LEO Pharma, Medexus, Novartis, Pediapharm, Pfizer, Sanofi Genzyme, Sun Pharma, Tribute, and UCB, 1, 2, 6, RAPT Therapeutics, Reistone, Sanofi Genzyme, Sun Pharma, Takeda, and UCB, 12, Investigator.

To cite this abstract in AMA style:

Sood S, Rimke A, Rankin B, Abduelmula A, Georgakopoulos j, Maliyar K, Bagit A, Leung F, Devani A, Vender R, Yeung J, Prajapati V. Real-world Experience of Bimekizumab for Plaque Psoriasis in Adult Patients with Prior Exposure to Interleukin-17 Inhibitors: A 16-week Multicenter Retrospective Review [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/real-world-experience-of-bimekizumab-for-plaque-psoriasis-in-adult-patients-with-prior-exposure-to-interleukin-17-inhibitors-a-16-week-multicenter-retrospective-review/. Accessed .

ACR Meeting Abstracts - https://acrabstracts.org/abstract/real-world-experience-of-bimekizumab-for-plaque-psoriasis-in-adult-patients-with-prior-exposure-to-interleukin-17-inhibitors-a-16-week-multicenter-retrospective-review/