Bimekizumab produced durable and generally strong clinical responses in patients with hidradenitis suppurativa (HS) regardless of how long they had lived with the disease, according to Raj Chovatiya, MD, PhD, discussing pooled 2-year data from the BE HEARD I, BE HEARD II, and BE HEARD EXT trials.1,2
Chovatiya, founder and director of the Center for Medical Dermatology + Immunology Research and associate professor at Rosalind Franklin University Chicago Medical School, noted the differences observed between disease duration quartiles were numerical rather than clearly statistically significant, with durability and overall effectiveness remaining strong across both groups. Small but increasing differences emerged only at the highest-threshold efficacy endpoints.
What Does Response Durability Look Like Across Disease Duration?
Patients maintained strong treatment durability whether their HS had been present for a few years or more than a decade, according to Chovatiya. He noted the analysis does not definitively establish a window-of-opportunity effect but represents some of the most compelling large clinical trial evidence to date supporting earlier intervention as a means of incrementally improving high-level outcomes.
What Are the Clinical Implications for Treatment Timing?
Chovatiya said clinicians should not assume advanced-stage HS precludes meaningful benefit from systemic therapy, noting efficacy was achieved with bimekizumab regardless of disease duration. He recommended engaging patients in systemic therapy discussions early after diagnosis rather than delaying treatment.
He pointed to ongoing unmet needs, including diagnostic delay, treatment delay, and variability in severity grading, all of which contribute to undertreatment of HS. Looking ahead, Chovatiya expressed hope that future research will help identify predictive factors, including disease duration, severity, and sociodemographic variables, to guide both treatment selection and timing of intervention.
Disclosures: Chovatiya previously reported serving as an advisor, consultant, speaker, and/or investigator for AbbVie, Amgen, Apogee Therapeutics, Arcutis, Argenx, ASLAN Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, Eli Lilly and Company, FIDE, Formation Bio, Galderma, Genentech, GSK, Incyte, LEO Pharma, L’Oréal, Nektar Therapeutics, Novartis, Opsidio, Pfizer Inc., Regeneron, RAPT, Sanofi, Sitryx, and UCB.
References
Chovatiya R, Alavi A, Miyagawa T. Bimekizumab 2-year efficacy by hidradenitis suppurativa duration: BE HEARD EXT results. J Eur Acad Dermatol Venereol. https://doi.org/10.1111/jdv.70631.
Chovatiya R. Bimekizumab efficacy by disease duration and severity in moderate to severe hidradenitis suppurativa: 3-year phase 3 results from BE HEARD EXT. 2026. AAD. #73498.
