Bimekizumab Long-term Efficacy in Patients with Moderate to Severe Plaque Psoriasis After Switching From Adalimumab, Ustekinumab, or Secukinumab: Results from Up to 4 Years of Total Treatment from BE BRIGHT and BE RADIANT

To achieve improvements in psoriasis management, patients and clinicians may choose to switch biologics, particularly in cases of suboptimal response and due to patient preference. 1 • It has been reported previously that, among patients with psoriasis who achieved ≥90% improvement from baseline in Psoriasis Area and Severity Index (PASI 90) with biologic therapy, approximately one-quarter lost their response at 6 months and half lost response at 18 months.2• Interleukin (IL)-17A and IL-17F have been identified as pivotal drivers of psoriasis and may be differentially regulated; 3 therefore, inhibiting both may offer additional benefits for patients.• Rapid skin clearance after switching to bimekizumab (BKZ) has previously been reported in patients who did not adequately respond to either adalimumab (ADA), ustekinumab (UST), or secukinumab (SEC), and these responses were maintained for up to 80 weeks after switch (2 years' total treatment). 1• Here, we investigate the impact of switching to BKZ on efficacy and health-related quality of life responses, and how they evolve in the long term following switch. ObjectiveTo investigate efficacy and health-related quality of life responses after switch to BKZ from ADA, UST, or SEC through 3 or 4 years of total treatment in the BE RADIANT and BE BRIGHT phase 3/3b studies, respectively. Methods• Included patients from BE BRIGHT were initially randomized to ADA to Week 24 followed by BKZ every 4 weeks (Q4W) to Week 56 (BE SURE), or to UST to Week 52 (BE VIVID), and then entered the BE BRIGHT open-label extension (OLE; 4 years' total treatment) where they received BKZ Q4W or every 8 weeks (Q8W; Figure 1).4-6 • Included patients from BE RADIANT (3 years' total treatment) received SEC to Week 48, followed by BKZ Q4W or Q8W during its OLE (Figure 1).7,8 • Here, PASI 90/PASI 100 and Dermatology Life Quality Index (DLQI) 0/1 responses are reported by number of weeks after switch to BKZ, in the long-term, grouped by observed PASI 90 response status at switch (regardless of BKZ dosing regimen).• Patients who discontinued due to lack of efficacy or treatment-related adverse events were considered non-responders at subsequent timepoints; multiple imputation was used for all other missing data (modified non-responder imputation; mNRI).Observed case (OC) data are also reported. Results• Baseline characteristics are shown in Table 1.• Of patients randomized to ADA, UST, and SEC at baseline who entered the respective OLEs, 54/129 (41.9%)ADA, 44/132 (33.3%)UST, and 58/314 (18.5%)SEC patients did not achieve PASI 90 at the time of switch to BKZ (Week 24, 52, and 48 respectively; OC).-At the time of switch, 29.6%, 50.0%, and 53.5% of PASI 90 non-responders had DLQI 0/1, respectively (mNRI).• In PASI 90 non-responders, following switch to BKZ, rapid responses were observed and maintained in the long term (mNRI; Figure 2):-Following switch from ADA and after 176 weeks of BKZ, 92.2%, 74.4%, and 81.0%achieved PASI 90, PASI 100, and DLQI 0/1, respectively;-Following switch from UST and after 144 weeks of BKZ, 82.0%, 58.8%, and 76.6% achieved PASI 90, PASI 100, and DLQI 0/1, respectively;-Following switch from SEC and after 96 weeks of BKZ, 71.7%, 39.8%, and 64.5% achieved PASI 90, PASI 100, and DLQI 0/1, respectively.• Switching ADA, UST, and SEC PASI 90 responders to BKZ resulted in maintained PASI 90, PASI 100, and DLQI 0/1 responses through 3 or 4 years of total treatment (Figure 3). ConclusionsSwitching adalimumab, ustekinumab, or secukinumab PASI 90 non-responders to bimekizumab led to rapid achievement and long-term maintenance of clinical responses, through 3 or 4 years of total treatment.In adalimumab, ustekinumab, or secukinumab PASI 90 responders, response rates were maintained in the long term following switch to bimekizumab.

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