Bimekizumab Effective in Bio-Naïve, Bio-Experienced Patients with Psoriasis

Bimekizumab is effective as a treatment for both bio-naïve and bio-experienced patients with psoriasis, new data suggest, though it may have a more rapid onset of action in those who are bio-naïve.1

These late-breaking data were presented during the 2025 European Academy of Dermatology and Venereology (EADV) Congress in Paris by investigator Tubanur Cetinarslan, MD, from the department of dermatology and venereology at Manisa Celal Bayar University in Türkiye. Cetinarslan et al set out to explore predictive factors for early super response to treatment with bimekizumab.

There were a total of 341 adult patients evaluated in this analysis. Among them, 39.9% presented with nail psoriasis, 43.4% presented with psoriatic arthritis (PsA), and 65.4% showed involvement of at least a single 'difficult-to-treat' region. In terms of treatment history, 45.5% of the participants were biologic-naïve, while 32.5% had previously been treated with 2 or more biologic therapies.

At the 4-week mark, either a ≥75% improvement in Psoriasis Area and Severity Index (PASI75), PASI90, or a PASI100 response was attained among 49.8% of subjects, 30.4%, and 17.6%, respectively. At the 24-week mark, these rates were shown to have risen substantially, with Cetinarslan and coauthors finding that 97.3% achieved PASI75, 93.9% achieved PASI90, and 74.8% achieved complete psoriasis clearance (PASI100).

Several factors were associated with reduced likelihood of being an early strong responder (ESR), including a positive family history (P = .041), palmoplantar involvement (P = .008), psoriatic arthritis (P = .097), and prior biologic exposure (P = .060). In addition, each one-point increase in baseline PASI score was linked to significantly lower odds of ESR (P < .001). However, biologic-naïve status did not influence PASI75, PASI90, or PASI100 responses at Weeks 16 or 24.

In their assessment of the most commonly reported adverse events, the most common was candidiasis, occurring in 13.7% of trial participants. Candida infection was significantly more common among those listed as female (P = .011), biologic-experienced subjects (P = .045), those with a family history of psoriasis (P = .014), and individuals with 2 or more prior biologic failures (P = .001).

The team also observed higher rates in individuals with longer disease duration (P = .002), cardiovascular disease (P = .009), and earlier age at the time of disease onset (P = .044). Infections were also shown by the investigators to have been linked with a lack of PASI75, PASI90, or PASI100 responses at the 4 (P = .011, P = .002, P = .003), 8 (P = .011, P = 0.009, P = .003), and 12-week marks (P = .721, P = .016, P = .012).

References

1. Cetinarslan T, Mergen M, Özyurt B, et al. Predictive Factors for Early Super Response to Bimekizumab in 341 Patients with Psoriasis -A 24 Week Short Term Multicenter Real Life Experience. Presented at the 2025 European Academy of Dermatology and Venereology (EADV) Congress, Sept 17-20, 2025.