Real-World Use of Bimekizumab Therapy in Patients with Difficult-to-Treat Plaque Psoriasis: A Retrospective Analysis from a Large Academic Center

Bimekizumab is a humanized monoclonal IgG1 antibody that selectively inhibits IL-17A and IL-17F, two cytokines that play a critical role in psoriasis vulgaris pathogenesis. Randomized clinical trials demonstrating the superiority of bimekizumab compared to placebo and other injectable biologics led to its approval by the United States FDA for moderate-to-severe plaque psoriasis. Due to the often-strict inclusion/exclusion criteria of randomized clinical trials, patient characteristics in real practice may drastically differ. Thus, the authors sought to investigate the use of this medication among real-world patients at their large academic center. Charts of patients prescribed bimekizumab between October 2023–April 2024 with a diagnosis of moderate-to-severe plaque psoriasis and follow-up within 6 months of medication initiation were included. Results showed that of the 24 patients prescribed bimekizumab, 83.3% (n=20) had concurrent diagnoses of psoriasis and psoriatic arthritis. At bimekizumab initiation, all patients had a baseline body surface area (BSA) affected by psoriasis of ≥10%, with mean BSA being 13.4%. After a mean of 163.5 days of therapy, BSA decreased to 3.8%. Overall, 83.3% of patients experienced a decrease in BSA after initiating bimekizumab, with 37.5% of patients obtaining a BSA of 0% (skin clear). Aligning with clinical trials, this study reinforces bimekizumab as a useful therapeutic option for moderate-to-severe plaque psoriasis. Future real-world research investigating bimekizumab would benefit from increased size and longer follow-up. Despite limitations, this study supports bimekizumab as an appropriate option for treatment of moderate-to-severe plaque psoriasis among patients in real clinical practice.