P113 Real-world experience of bimekizumab for plaque psoriasis in adult patients with prior exposure to interleukin-23 inhibitors: a 16-week multicentre retrospective cohort study
Year: 2024
Type: conference-abstract
Abstract: For adult patients with plaque psoriasis, limited information exists on switching between classes from an IL-23 inhibitor (IL-23i) to bimekizumab. We conducted a real-world, multicentre, retrospective study of bimekizumab use in the setting of prior IL-23i exposure. A total of 26 patients with prior IL-23i exposure were identified. Effectiveness outcomes included Investigator Global Assessment (IGA), psoriasis area and severity index (PASI), body surface area (BSA), and IGA × BSA scores. Safety was assessed via treatment-related adverse events (AEs). Mean age was 44.0 (range: 18–76) years, with 57.7% (15/26) being female. Prior IL-23i exposures included guselkumab only (46.2%, 12/26), risankizumab only (34.6%, 9/26), and both guselkumab and risankizumab (19.2%, 5/26). All 26 patients discontinued the IL-23i agent due to inefficacy. Primary non-response to IL-23i 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 at any point afterwards. At Weeks 16 ± 6: IGA 0/1 was achieved by 82.6% (19/23); mean PASI, BSA, and IGA × BSA improvements from baseline were 77.5% (7.2–0.9), 81.8% (6.8–0.9%), and 86.9% (19.4–1.3), respectively; 73.1% (19/26), 53.9% (14/26), and 30.8% (8/26) achieved PASI75, 90% improvement in PASI (PASI90), and 100% improvement in PASI (PASI100), respectively; 96.2% (25/26), 92.3% (24/26), and 69.2% (18/26) achieved absolute PASI scores <3, <2, and <1; and 73.1% (19/26) achieved BSA <1%. In prior IL-23i primary non-responders (n = 4), 100% (4/4) achieved IGA 0/1 and/or PASI90; however, none achieved PASI100, with bimekizumab at Week 16 ± 6. In prior IL-23i secondary non-responders (n = 16), 75% (12/16) achieved IGA 0/1 and/or PASI90 and 43.8% (7/16) achieved PASI100 with bimekizumab at Week 16 ± 6. Three treatment-related AEs occurred (11.5%, 3/26), including oral candidiasis (7.7%, 2/26) and folliculitis (3.8%, 1/26); none led to discontinuation. In comparison to clinical trials and an Italian real-world study of biologic-experienced patients (n = 103), our study of bimekizumab in IL-23i-exposed patients demonstrated lower response for PASI90 [85–91% (trials) vs. 87.9% (Italian study) vs. 53.9% (our study)] and PASI100 [59–83% (trials) vs. 74.1% (Italian study) vs. 30.8% (our study)]. This discrepancy may be explained by a more difficult-to-treat population with multiple biologic failures [42.3% utilized >3 biologics (our study) vs. 18.6% with >2 biologics (Italian study)] and IL-23i secondary failures [61.5% (our study)]. Our study included patients with >1 biologic failure, while Phase III clinical trials excluded this population. We highlight the utility of bimekizumab despite IL-23i exposure. Study limitations include its small sample and retrospective nature.
Source: British Journal of Dermatology
Language: English
Subfield: Immunology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: bronze
OpenAlex ID: W4405229978