Bimekizumab Shows Long-Term Remission in Severe Psoriasis | Healio

A new analysis of long-term data suggests that bimekizumab, a relatively recent addition to the psoriasis treatment landscape, can maintain significant skin clearance for up to three years in many patients with moderate to severe plaque psoriasis. The findings, presented at the Winter Clinical Conference in Miami, offer encouraging evidence for the durability of response with this dual IL-17A and -17F inhibitor.

Long-Term Remission Rates

The research pooled data from five phase 3 clinical trials – BE SURE, BE READY, BE VIVID, BE BRIGHT, and BE RADIANT – encompassing a total of 615 participants who completed three years of treatment without missing any key assessments of disease severity. Almost 90% of these individuals achieved what the National Psoriasis Foundation (NPF) defines as on-treatment remission for more than six months at some point during the study period. This definition requires continuous maintenance of completely clear skin (0% body surface area involvement) or an Investigator’s Global Assessment (IGA) score of 0.

The data showed a sustained benefit over time. More than 75% of participants maintained remission for 12 months or longer, and over half achieved remission lasting 24 months or longer. Researchers similarly observed high rates of PASI 100 – a measure of complete skin clearance – with 87.8%, 76.7%, and 56.1% of patients achieving this level of improvement for more than 6, 12, and 24 months, respectively. Bimekizumab (Bimzelx, UCB) was generally administered every four weeks, with some patients transitioning to an every-eight-week schedule.

Quality of Life Improvements

Beyond skin clearance, the study also highlighted significant improvements in patients’ quality of life, as measured by the Dermatology Life Quality Index (DLQI). 80% of participants reported a DLQI score of 0 or 1 at week 16, indicating minimal impact of their psoriasis on their daily lives. Importantly, these improvements were sustained through year 3, with over 90% of participants maintaining those low DLQI scores.

Evolving Psoriasis Treatment

These findings reflect a broader shift in the treatment of psoriasis over the past two decades, according to April W. Armstrong, MD, MPH, professor and chief of dermatology at University of California, Los Angeles. “Especially in the last 5 years, developments in both biologic and oral medicines translate to even higher efficacy,” Armstrong told Healio. “Prior to the last 5 to 10 years, available treatments could bring significant improvement, but patients would still have plaques here and there. Our new treatments can now bring the majority of our patients to complete clearance.”

The NPF formally defined on-treatment remission in 2025, recognizing the potential for sustained disease control with newer therapies. This definition, based on continuous maintenance of clear or nearly clear skin for at least six months, provides a standardized benchmark for evaluating treatment success.

Understanding Bimekizumab’s Mechanism

Bimekizumab distinguishes itself from some other psoriasis treatments by targeting both interleukin-17A (IL-17A) and interleukin-17F (IL-17F), two key proteins involved in the inflammatory processes that drive psoriasis. By blocking both of these cytokines, bimekizumab aims to provide more comprehensive disease control. UCB, the manufacturer of bimekizumab, provides detailed information about the drug’s mechanism of action on their website.

Clinical Trial Details and Considerations

The data presented at the Winter Clinical Conference were derived from pooled analyses of several phase 3 trials. These trials typically involve a rigorous study design, including randomized controlled comparisons against placebo or other established treatments. However, it’s important to note that clinical trials often have specific inclusion and exclusion criteria, meaning that the results may not be directly generalizable to all patients with psoriasis. For example, participants in these trials may have had moderate to severe psoriasis but may not have had other significant health conditions that could influence treatment outcomes.

Implications for Clinical Practice

Armstrong suggests that these data support a strategy of maintaining patients on bimekizumab once they achieve a positive response. “The implication for clinicians is that once a patient is on bimekizumab, the likelihood of needing to switch them off is very low,” she said. “Importantly for patients, they can feel that they are on a drug that will really keep their skin clear over a long period of time, and the vast majority do not have to worry about flaring or significant recurrence.”

However, it’s crucial for clinicians to individualize treatment decisions based on each patient’s specific circumstances, considering factors such as disease severity, other medical conditions, and potential side effects. The National Psoriasis Foundation offers comprehensive resources for patients and healthcare professionals, including information on treatment options and disease management.

What to Expect Next

Further research will continue to evaluate the long-term safety and efficacy of bimekizumab, as well as its potential role in combination with other therapies. Ongoing surveillance and real-world data collection will provide valuable insights into how the drug performs in broader patient populations. Clinicians should stay abreast of emerging evidence and updated treatment guidelines to provide the best possible care for their patients with psoriasis.

April W. Armstrong, MD, MPH, can be reached at [email protected]; Instagram: @aprilarmstrongmd.