Bimekizumab treatment in biologic DMARD-naïve patients with active psoriatic arthritis: 52-week efficacy and safety results from the phase III, randomised, placebo-controlled, active reference BE OPTIMAL study.

Publication Title

Annals of the rheumatic diseases

Document Type

Article

Publication Date

11-1-2023

Keywords

washington; swedish; swedish neuro; arthritis, psoriatic; biological therapy; psoriatic arthritis; Humans; Arthritis, Psoriatic; Treatment Outcome; Antirheumatic Agents; Adalimumab; Antibodies, Monoclonal; Psoriasis; Biological Products; Double-Blind Method; Severity of Illness Index

Abstract

OBJECTIVES: Bimekizumab (BKZ) is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17F in addition to IL-17A. BKZ treatment has demonstrated superior efficacy versus placebo (PBO) at Week 16 in biologic disease-modifying antirheumatic drug (DMARD)-naïve patients with active psoriatic arthritis (PsA). Here, we report long-term efficacy and safety to Week 52.

METHODS: BE OPTIMAL comprised a 16-week, double-blind, PBO-controlled period, then 36 weeks treatment-blind. Patients were randomised 3:2:1 to subcutaneous BKZ 160 mg every 4 weeks, PBO with switch to BKZ at Week 16, or reference arm (adalimumab (ADA) 40 mg every 2 weeks). Efficacy outcomes included the American College of Rheumatology (ACR) response criteria 20/50/70, Psoriasis Area and Severity Index (PASI) 75/90/100 in patients with baseline psoriasis affecting =3% body surface area and minimal disease activity (MDA); non-responder imputation.

RESULTS: ACR20/50/70, PASI75/90/100 and MDA responses were sustained with BKZ to Week 52, consistent with results observed at Week 16. Patients who switched to BKZ at Week 16 demonstrated improvements in efficacy with similar results to BKZ-randomised patients by Week 52.To Week 52, 555/702 (79.1%) patients had =1 treatment-emergent adverse event (TEAE) during BKZ treatment; 113/140 (80.7%) on ADA. On BKZ, 46 (6.6%) patients had serious TEAEs. 54 (7.7%)

CONCLUSIONS: The efficacy of BKZ in bDMARD-naïve patients with PsA was sustained from Week 16 to Week 52. BKZ was well tolerated with no new safety signals observed.

TRIAL REGISTRATION NUMBER: NCT03895203.

Area of Special Interest

Orthopedics & Sports Medicine

Area of Special Interest

Neurosciences (Brain & Spine)

Specialty/Research Institute

Rheumatology

Specialty/Research Institute

Neurosciences

DOI

10.1136/ard-2023-224431

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