Earlier bimekizumab (Bimzelx) treatment has been linked with higher rates of complete inflammatory lesion resolution through 3 years in moderate to severe hidradenitis suppurativa (HS), post hoc analyses of the phase 3 BE HEARD I and II trials and the BE HEARD EXT open-label extension suggest.¹˒²
These data were presented by UCB at the 2026 European Academy of Dermatology and Venereology (EADV) Congress. The analyses were among 9 HS-focused abstracts UCB brought to the congress in Vienna, Austria. Additional findings addressed draining tunnels by prior biologic exposure, total tunnel counts, quality of life, and long-term safety.¹
Bimekizumab selectively inhibits both interleukin 17F (IL-17F) and IL-17A. According to UCB, IL-17F is more abundant than IL-17A in HS serum and lesional skin, with the highest expression found in draining tunnels.¹
Does Earlier Bimekizumab Treatment Improve Outcomes in Hidradenitis Suppurativa?
Investigators compared International HS Severity Score System (IHS4) responses between patients in the shortest disease duration quartile (less than 2.38 years since diagnosis; n = 97) and the longest (10.74 years or more; n = 81). At 3 years, complete resolution of inflammatory lesions, or IHS4-100, occurred in 47.4% of the shortest-duration group versus 33.3% of the longest-duration group.¹˒²
IHS4-90 responses followed a similar pattern, at 62.9% versus 53.1%, as did IHS4-75 responses, at 79.4% versus 70.4%. IHS4-55 rates were comparable, at 89.7% and 91.4%, respectively.¹
Prior biologic use also appeared to influence draining tunnel outcomes. At 3 years, 67.3% of biologic-naive patients achieved complete draining tunnel resolution compared with 47.7% of biologic-experienced patients.¹˒³
Mean draining tunnel count fell from 3.3 to 0.8 among biologic-naive patients and from 5.6 to 1.3 among biologic-experienced patients over the same period.¹
Did Bimekizumab Reduce Total Tunnels in Hidradenitis Suppurativa?
A pooled 1-year analysis from BE HEARD I and II examined total tunnels, encompassing both draining and nondraining tracts. At the point of baseline, 14.5% of 868 patients had no tunnels of any kind; among 613 patients completing the first year, this proportion rose to 30.7%.¹˒⁴
Over the same period, the share of individuals assessed with no draining tunnels increased from 27.0% to 56.6%. Draining tunnels made up 37.3% of all tunnels at the 16-week mark and 31.3% at 1 year.¹
Amit Garg, MD, of the Zucker School of Medicine at Hofstra/Northwell, characterized the total tunnel data as the first evidence of an HS therapy reducing overall tunnel burden. He suggested the data may suggest an effect on disease progression.¹
What Did the 3-year Quality of Life and Safety Data Show?
Mean Dermatology Life Quality Index (DLQI) scores declined from 11.0 at baseline to 4.5 at 3 years, with 38.1% of patients reaching DLQI 0/1 and 71.7% reaching DLQI 0 to 5. The share of patients with an HS Quality of Life (HiSQOL) total score of 14 or lower increased from 24.1% to 76.4%.¹˒⁵
Mean symptom scores for skin pain, itch, odor, and drainage each dropped from moderate to severe levels at baseline to mild levels at 3 years.¹
The safety analysis included 995 subjects with 2118.6 patient-years of exposure. The exposure-adjusted incidence rate of any treatment-emergent adverse event was 243.3 per 100 patient-years, with HS, coronavirus infection, and oral candidiasis most common. UCB reported a lack of new safety signals and no increase in risk with longer exposure.¹˒⁶
Fungal infections occurred at a rate of 22.4 per 100 patient-years, including Candida infections at 13.5 per 100 patient-years.¹
All efficacy analyses were post hoc and used observed case data, and UCB noted the results should be interpreted with caution. The approved HS regimen is 320 mg every 2 weeks through week 16, followed by 320 mg every 4 weeks.¹
Editor's Note: This summary has been edited for grammar and clarity using artificial intelligence tools.
References
Tzellos T, et al. Bimekizumab efficacy on IHS4 response levels and draining tunnels by HS disease duration over 3 years: data from BE HEARD EXT. Poster P1334. Presented at: 2026 European Academy of Dermatology and Venereology Congress; September 30-October 3, 2026; Vienna, Austria.
Martorell A, et al. Bimekizumab improves draining tunnel outcomes in patients with moderate to severe HS regardless of prior biologic use: 3-year data from BE HEARD EXT. Poster P1348. Presented at: 2026 European Academy of Dermatology and Venereology Congress; September 30-October 3, 2026; Vienna, Austria.
Bechara F, et al. Bimekizumab treatment reduces tunnels in patients with moderate to severe hidradenitis suppurativa: pooled 1-year results from BE HEARD I&II. Poster P1389. Presented at: 2026 European Academy of Dermatology and Venereology Congress; September 30-October 3, 2026; Vienna, Austria.
Szepietowski J, et al. Bimekizumab effect on health-related quality of life and symptoms over 3 years: data from BE HEARD EXT. Poster P1344. Presented at: 2026 European Academy of Dermatology and Venereology Congress; September 30-October 3, 2026; Vienna, Austria.
Garg A, et al. Bimekizumab safety and tolerability in patients with moderate to severe hidradenitis suppurativa: 3-year results from BE HEARD EXT. Poster P0040. Presented at: 2026 European Academy of Dermatology and Venereology Congress; September 30-October 3, 2026; Vienna, Austria.
