An Overview of Bimekizumab for the Treatment of Psoriatic Arthritis: The Evidence so Far

Abstract

Psoriatic arthritis is a complex and heterogeneous disease with potential significant disability and impaired quality of life. Although in the last decades new treatment options have led to a better management of this disease, there are still significant unmet therapeutic needs. Dual inhibitor antibodies target two different cytokines simultaneously, potentially offering a better disease control. In psoriatic arthritis, there is evidence for a pathogenic role not only of IL-17A but also the structurally homologous IL-17F. It is postulated that differential expression of both in several targets of PsA could account for disparities in clinical response to IL-17A inhibition alone (such as with secukinumab or ixekizumab). Here we review the evidence so far for the use in psoriatic arthritis of bimekizumab, the first humanized monoclonal IgG1 antibody that selectively neutralizes both IL-17A and IL-17F. A Phase 2b trial reports better outcomes over both placebo and IL-17A inhibition alone. Very recently encouraging results from open-label extensions with regards to both safety and maintenance of response were presented. Phase III trials are ongoing with the first results awaited in 2021.

Dual inhibition of IL-17A and IL-17F in psoriatic disease

“… 36 Bispecific antibodies might bind preferentially to cells containing both targets instead of those expressing only one (avidity hypothesis), 48 and become an interesting option for patients with IL-17 signaling pathway-refractory disease. 62 …”

“…36 Bispecific antibodies might bind preferentially to cells containing both targets instead of those expressing only one (avidity hypothesis), 48 and become an interesting option for patients with IL-17 signaling pathway-refractory disease. 62 In 33,63 In addition, the efficacy of bimekizumab has been tested in patients with BSA ⩽5. 36 Furthermore, in its proof-of-concept trial, sonelokimab has shown some of the highest levels of efficacy so far, achieving PASI90 in 100% of patients at day 85.…”

Vaccinations in Patients Receiving Systemic Drugs for Skin Disorders: What Can We Learn for SARS-Cov-2 Vaccination Strategies?

“…Similar reassuring data have been reported for tetanus and pneumococcal vaccination for ixekizumab [ 45 ]. Secukinumab has a half-life of 27 days, ixekizumab 13 days, brodalumab 10.9 days, and bimekizumab 17–26 days [ 46 – 49 ]. No reports have been published on brodalumab and bimekizumab.…”

Insights into the Pathogenesis of HS and Therapeutical Approaches

“…Bimekizumab is a humanized IgG1 monoclonal antibody that selectively neutralizes both IL-17A and IL-17F, functioning as a dual inhibitor [ 236 ]. A phase 2 multicenter trial to test the efficacy, safety, and pharmacokinetics of bimekizumab in moderate-to-severe HS patients was completed (ClinicalTrials.gov Identifier: NCT03248531).…”