BE ACTIVE: IL-17F, IL-17A blockade may ‘push the envelope’ for PsA treatment
BOSTON — Bimekizumab, a humanized IgG1 monoclonal antibody that inhibits both interleukin-17F and interleukin-17A, was associated with improved ACR20 response rates in patients with psoriatic arthritis within 2 weeks of first infusion, according to findings from the phase 2b BE ACTIVE study presented here.
During his presentation at the 2018 Interdisciplinary Autoimmune Summit, Joseph F. Merola, MD, MMSc, of Harvard University and Brigham and Women’s Hospital, also noted that 80% of patients with PsA in the study achieved ACR20 response by week 8.
“This is the audience gasp moment,” he said, addressing a session at the 2018 Interdisciplinary Autoimmune Summit. “This is exciting, and we will have to see how this plays out, but there is reason to be optimistic that perhaps blockade of IL-17A and IL-17F will help push the envelope a little for PsA patients, with more to come.”
Bimekizumab, an emerging treatment that has not yet been approved for psoriatic arthritis, also demonstrated an ACR50 response rate of 57% at week 12 and an ACR70 response of 37% at week 16, he added. It also achieved these primary and secondary clinical response thresholds in a significantly greater number of patients than placebo across multiple doses. In addition, bimekizumab was well tolerated, with no new safety signals – nasopharyngitis was the most frequently reported adverse event.
According to Merola, the study was based on the hypothesis that IL-17F blockade, in addition to IL-17A inhibition, plays an important role in immune-mediated chronic inflammation. Both IL-17A and IL-17F share approximately 50% structural homology and have overlapping biologic functions, he said. In addition, both are expressed at sites of inflammation and independently cooperate with other cytokines to mediate chronic inflammation.
“The question is, are we getting added benefit from the blockade of IL-17F in addition to IL-17A?” Merola said. “At least early on, there is reason to be optimistic. This is about as exciting as it gets for a derm-rheum guy like me.” – by Jason Laday
Merola JF. Psoriatic Arthritis: New Choices and Treatment Options. Presented at: The Interdisciplinary Autoimmune Summit 2018; April 27-29; Boston.
Disclosure: Merola reports advisory board membership with AbbVie, Amgen, Biogen IDEC, Janssen, Kiniksa, Mallinckrodt, Momenta, Novartis, Pfizer and UCB; as well as consulting fees from AbbVie, Amgen, Biogen IDEC, Celegene, Eli Lilly,GSK, Janssen, Kiniksa, Mallinckrodt, Momenta, Novartis, Pfizer, Sanofi, Science 37, Sumumed and UCB; speaking fees from AbbVie; and being an investigator with Biogen IDEC.