Bimekizumab may be effective hidradenitis suppurativa treatment

Bimekizumab showed clinically meaningful improvements in hidradenitis suppurativa in a phase 2 trial.

“Despite the relatively high prevalence and severe impact of HS, few treatment options are available,” Sophie Glatt, MD, of UCB Pharma, and colleagues wrote. “Interleukin (IL) 17A and IL-17F have been identified as drivers of chronic joint and skin inflammation, share approximately half their structural homology and have overlapping proinflammatory functions.”

Bimekizumab (UCB), an IL-17A and IL-17F inhibitor, has shown promising improvements in other dermatologic and rheumatologic diseases.

Researchers in the randomized, double-blind clinical trial evaluated bimekizumab’s efficacy and safety in 88 patients with moderate to severe HS (69% female; median age, 36 years) randomly assigned 2:1:1 to receive bimekizumab (640 mg at week 0, 320 mg every 2 weeks), placebo or adalimumab (160 mg at week 0, 80 mg at week 2 and 40 mg every week for weeks 4 to 10).

The study’s primary efficacy endpoint was the proportion of subjects who achieved Hidradenitis Suppurativa Clinical Response (HiSCR) at week 12, which consisted of a 50% or greater reduction in the total abscess and inflammatory nodule count with no increase in abscess or draining fistula count.

Seventy-nine subjects completed the study through 12 weeks, and 73 completed the entire study, which included a safety follow-up period.

At week 12, HiSCR was 57.3% in the bimekizumab group and 26.1% in the placebo group (95% credible interval for difference, 11% to 50.4%; posterior probability of superiority = 0.998).

International Hidradenitis Suppurativa Severity Score improvements were also seen at week 12 in the treatment group compared with placebo.

Treatment-emergent adverse events were similar in all three treatment arms, and most were mild or moderate. One patient in the bimekizumab group discontinued treatment due to worsening HS.

“In this phase 2 randomized clinical trial, bimekizumab demonstrated clinically meaningful and consistent improvements vs. placebo across all assessed outcome measures, from as early as week 2 through week 12, in participants with moderate to severe HS,” the authors wrote. “These data suggest that dual inhibition of IL-17A and IL-17F by bimekizumab may be a viable treatment approach for HS, with the potential to achieve deep responses in clinical outcomes.”