Andrew Dorizas, MD, FAAD, ASMS

In this episode, the panelists review long-term efficacy data for bimekizumab presented at EADV 2025, focusing on sustained remission and disease control in psoriasis. The experts highlight that approximately 49% of patients maintained complete skin clearance (PASI 100) from month 4 through year 4, with about 72% sustaining complete or near-complete clearance over the same period. They interpret these findings as strong evidence of durability and depth of response, underscoring bimekizumab’s ability to maintain remission over years rather than months. The discussion also includes nail outcomes, with nearly 80% of patients maintaining NAPSI 0, indicating resolution of nail involvement—an important factor given its association with psoriatic arthritis risk. The panelists emphasize that by achieving and maintaining high levels of clearance in both skin and nails, bimekizumab may help interrupt the inflammatory progression that leads to PsA, reinforcing its role in comprehensive disease control.

Evaluating Long-Term Remission and Disease Control with Bimekizumab in Psoriasis

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In this episode, the panelists discuss how the definition of treatment success and remission in psoriasis has evolved. Historically, achieving PASI 75 was considered adequate, but the experts explain that PASI 100, or complete skin clearance, is now the preferred benchmark. They reference the National Psoriasis Foundation’s 2025 consensus statement, which defines remission as maintaining ≤1% body surface area involvement for at least six months and a DLQI score of 0 or 1, indicating no impact on quality of life. The panelists emphasize that complete skin clearance reflects a deeper suppression of systemic inflammation and may reduce the risk of psoriatic arthritis. They also highlight that visible clearance serves as a practical measure in the absence of validated biomarkers. With current systemic therapies making PASI 100 an attainable goal, the experts agree that striving for sustained remission represents both clinical success and improved long-term outcomes.

Redefining Treatment Success and Remission in Psoriasis Care

In this episode, the panelists address key barriers to adopting a preventive treatment approach in psoriatic disease. The experts agree that insurance approval and prior authorization processes remain the most significant obstacles to initiating early systemic therapy. They describe the administrative challenges involved, including formulary restrictions, step therapy requirements, and the extensive time needed to secure coverage. Many dermatology practices have responded by employing biologic coordinators to handle these complex approval procedures, allowing clinicians to focus on patient care. The panelists also discuss patient-driven barriers, such as direct-to-consumer advertising that influences medication requests, and cases where patients seek drugs inappropriate for their specific disease subtype. Through these examples, the experts highlight how both system-level hurdles and patient perceptions can delay optimal therapy. They emphasize the importance of advocacy, education, and workflow support to overcome these barriers and enable earlier, prevention-focused management of psoriatic disease.

Barriers to a Preventive Approach in Psoriatic Disease

In this episode, the panelists explore how to balance the benefits and risks of initiating systemic therapy early in patients with psoriasis who do not yet have joint involvement. The experts discuss that starting treatment is more straightforward in patients with moderate to severe plaque psoriasis, where strong clinical data support systemic use. However, the decision becomes more nuanced for those with limited disease. In such cases, factors like lesion location (nail, scalp, or other special sites), previous treatment failures, and patient motivation play an important role. The panel emphasizes the importance of shared decision-making, considering both the clinical picture and patient preferences. They note that even in mild cases, residual skin inflammation reflects ongoing systemic activity, and early therapy may still provide long-term benefits. The experts conclude that treatment should address both disease burden and patient quality of life, while maintaining a risk–benefit balance.

Andrew Dorizas, MD, FAAD, ASMS

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