The U.S. Food and Drug Administration (FDA) has approved bimekizumab-bkzx (Bimzelx) for the treatment of adults with moderate to severe hidradenitis suppurativa (HS), offering a novel approach to managing this chronic inflammatory skin condition. Bimekizumab, developed by UCB, is the first approved therapy for HS that selectively inhibits both interleukin (IL)-17A and IL-17F.
Dual IL-17 Inhibition
Bimekizumab's mechanism of action involves the dual inhibition of IL-17A and IL-17F, cytokines critical in the inflammatory processes underlying HS. This targeted approach aims to modulate immune responses, addressing the chronic inflammation and tissue destruction characteristic of HS. According to Christopher Bunick, MD, PhD, associate professor at Yale University School of Medicine, this dual neutralization will raise the standards of care for HS patients, delivering much-needed clinical, psychological, and social improvements.
Efficacy and Safety Data
The FDA's approval was supported by data from the pivotal Phase 3 trials, BE HEARD I and BE HEARD II, which were randomized, double-blind, placebo-controlled studies. These trials evaluated the efficacy and safety of bimekizumab in adult patients with moderate to severe HS.
Key findings from the trials include:
- Primary Endpoint Achievement: At week 16, a significantly greater proportion of patients receiving bimekizumab achieved HS Clinical Response (HiSCR) 50 (≥50% reduction in inflammatory nodule and abscess count with no increase in draining fistulas) compared to placebo.
- Sustained Responses: Clinical improvements, as evidenced by HiSCR75 (≥75% reduction in HS signs and symptoms), were sustained through week 48.
- Safety Profile: Bimekizumab exhibited a favorable safety profile, consistent with previous clinical trials, with no new safety signals emerging during the study period.
Alexa B. Kimball, MD, MPH, from Beth Israel Deaconess Medical Center and Harvard Medical School, noted that the approval of bimekizumab is welcome given the substantial unmet clinical needs and limited treatment options currently available for HS. She highlighted that patients treated with bimekizumab achieved deep and sustained clinical responses up to 48 weeks in the Phase 3 clinical studies.
Broader Implications
This approval marks bimekizumab's fifth FDA-sanctioned indication, following previous approvals for moderate to severe plaque psoriasis, active psoriatic arthritis, non-radiographic axial spondyloarthritis, and ankylosing spondylitis. Emmanuel Caeymaex, Executive Vice President, Head of Patient Impact and Chief Commercial Officer at UCB, stated that this approval represents a significant step forward in alleviating the global burden of immune-mediated inflammatory diseases. He emphasized UCB's commitment to addressing unmet needs in HS and other immunological conditions by delivering innovative medicines and raising standards of care.
With approximately one in 100 people affected by HS, the approval of bimekizumab offers a new treatment option for those living with this chronic and painful disease.
