Perspective from Jerry Bagel, MD, MS
Disclosures: Lebwohl reports he is an employee of Mount Sinai Hospital, which receives research funds from AbbVie, Amgen, Arcutis, Boehringer Ingelheim, Dermavant, Eli Lilly, Incyte, Janssen Research & Development, Leo Pharma, Ortho Dermatologics, Pfizer and UCB Pharma, and is a consultant for Aditum Bio, Allergan, Almirall, Arcutis, Avotres Therapeutics, BirchBioMed, BMD Skincare, Boehringer Ingelheim, BMS, Cara Therapeutics, Castle Biosciences, Corrona, Dermavant Sciences, Evelo, Facilitate International Dermatologic Education, Foundation for Research and Education in Dermatology, Inozyme Pharma, Leo Pharma, Meiji Seika Pharma, Menlo, Mitsubishi, NeuroDerm, Pfizer, Promius/Dr Reddy’s Laboratories, Serono, Theravance and Verrica. Please see the study for all other authors’ relevant financial disclosures.
February 10, 2021
4 min read
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Bimekizumab shows rapid, effective treatment of plaque psoriasis

Perspective from Jerry Bagel, MD, MS
Disclosures: Lebwohl reports he is an employee of Mount Sinai Hospital, which receives research funds from AbbVie, Amgen, Arcutis, Boehringer Ingelheim, Dermavant, Eli Lilly, Incyte, Janssen Research & Development, Leo Pharma, Ortho Dermatologics, Pfizer and UCB Pharma, and is a consultant for Aditum Bio, Allergan, Almirall, Arcutis, Avotres Therapeutics, BirchBioMed, BMD Skincare, Boehringer Ingelheim, BMS, Cara Therapeutics, Castle Biosciences, Corrona, Dermavant Sciences, Evelo, Facilitate International Dermatologic Education, Foundation for Research and Education in Dermatology, Inozyme Pharma, Leo Pharma, Meiji Seika Pharma, Menlo, Mitsubishi, NeuroDerm, Pfizer, Promius/Dr Reddy’s Laboratories, Serono, Theravance and Verrica. Please see the study for all other authors’ relevant financial disclosures.
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A phase 3 study found bimekizumab to be more efficacious in the treatment of plaque psoriasis than both ustekinumab and placebo.

“Bimekizumab differs from other [interleukin] drugs currently available in that it blocks two molecules, IL-17A and IL-17F,” Mark Lebwohl, MD, one of the study’s authors and Waldman Chair of Dermatology at the Icahn School of Medicine at Mount Sinai, told Healio. “There’s a big overlap between those molecules in the body. ... One of the things they do is they cause psoriasis.”

Bimekizumab was more efficacious than ustekinumab and placebo in the treatment of moderate to severe plaque psoriasis.

The multicenter, randomized, double-blind, active-comparator, placebo-controlled BE VIVID trial included 567 patients and took place at 105 locations across 11 countries.

Mark Lebwohl

Subjects were randomly assigned 4:2:1 to receive bimekizumab 320 mg every 4 weeks, ustekinumab 45 mg or 90 mg (weight-dependent dosing) at weeks 0 and 4 and then every 12 weeks, or placebo every 4 weeks. Evaluations were conducted at weeks 1, 2 and 4 and then every 4 weeks through week 52.

At week 16, 85% of those in the bimekizumab group had a 90% improvement in Psoriasis Area Severity Index score compared with 50% in the ustekinumab group and 5% in the placebo group (both P < .0001).

PASI 100 was observed in 59% of subjects in the bimekizumab group at week 16 compared with 21% in the ustekinumab group and 0% in the placebo group (both P < .0001).

“To this day, we have never before had a drug that at the end of the placebo-control period of a study has a majority of patients achieving PASI 100, meaning not a dot of psoriasis left,” Lebwohl said.

At week 52, 82% of bimekizumab subjects still had a score of PASI 90 compared with 56% of ustekinumab subjects and 0% of placebo subjects.

Investigator’s Global Assessment response was also greater at all time points for bimekizumab than either ustekinumab or placebo.

In addition, the speed of bimekizumab’s effectiveness was noted.

“This drug was incredibly fast. At week 4, 76.9% of patients achieved PASI 75,” Lebwohl said. “The magnitude of the response and the speed of the response beat everything else we have. This gives us a drug that is safe, effective and works to a degree we haven’t seen before. It gives us yet another option to improve the effectiveness of the current armamentarium of psoriasis that we have.”