Long-Term Data on Bimekizumab in HS and Its Clinical Implications

Two-year efficacy data for bimekizumab demonstrate sustained and progressive improvement in hidradenitis suppurativa (HS) outcomes, with patients typically reaching peak response around 6 months of treatment. At the 2-year mark, approximately one-third to nearly half of patients achieve HiSCR100 (complete resolution of inflammatory lesions), while over two-thirds reach HiSCR75 (75% improvement), representing clinically meaningful disease control that significantly impacts patient satisfaction and treatment adherence. The data show progressive improvement in all lesion types, with particularly notable reductions in draining tunnel counts and associated pain scores.

Safety data through 2 years confirm manageable adverse event profiles, though cutaneous reactions emerged as a notable concern requiring clinical attention. These skin reactions, sometimes characterized as eczematous or psoriasiform, can occur in intertriginous areas including over HS lesions themselves, potentially causing itching and burning sensations that may initially be mistaken for disease worsening or contact dermatitis from bandages. The incidence of oral candidiasis, an anticipated adverse effect of IL-17 inhibition, tends to decrease over time with continued treatment.

Clinical management strategies based on long-term data emphasize patient counseling about the expected timeline for improvement, with 3-month follow-up appointments serving as critical assessment points for determining treatment response and optimization needs. Practitioners coach patients that meaningful improvement requires patience, typically 3 to 6 months, though they should report any concerning cutaneous reactions promptly for early intervention. The data support continuing therapy through initial months even without dramatic improvement, as many patients show progressive benefit extending well beyond the first assessment period.