A groundbreaking real-world study comparing two leading IL-17 inhibitors has demonstrated superior efficacy for bimekizumab over brodalumab in treating moderate to severe psoriasis, marking the first head-to-head comparison of these treatments in a clinical setting.
The retrospective analysis, published in Dermatology and Therapy, evaluated 125 patients over 36 weeks, with 53 receiving bimekizumab and 72 receiving brodalumab. Both medications showed significant effectiveness in reducing psoriasis severity, but bimekizumab emerged as the stronger performer in several key metrics.
Superior Clinical Response with Bimekizumab
Bimekizumab demonstrated notably higher complete clearance rates, achieving significantly greater PASI 100 responses compared to brodalumab at week 4 (41.5% vs 23.6%, P < .05) and week 16 (67.9% vs 48.6%). This superior performance in skin clearance highlights bimekizumab's potential as a preferred treatment option for patients seeking rapid and complete disease resolution.
Treatment Persistence and Safety Profiles
The study revealed important differences in treatment continuation patterns. Brodalumab showed a higher discontinuation rate due to inefficacy at 8.3%, compared to just 3.8% for bimekizumab, though this difference did not reach statistical significance. However, bimekizumab had a slightly higher rate of adverse event-related discontinuations (5.7%) compared to brodalumab (1.4%).
Safety Considerations and Adverse Events
Both treatments demonstrated manageable safety profiles, though with distinct patterns of adverse events. The bimekizumab group experienced two cases of eczematous reactions and four cases of candidiasis, while the brodalumab group reported one case of candidiasis. These findings provide valuable insights for clinicians in managing treatment-specific risks.
Clinical Implications for Psoriasis Management
This real-world evidence offers crucial guidance for dermatologists and healthcare providers in selecting between these IL-17 inhibitors. The data suggests that while both medications are effective, bimekizumab may be particularly suitable for patients prioritizing rapid and complete skin clearance.
Study Limitations and Future Research
The researchers acknowledge several limitations, including the retrospective design, modest sample size, and uneven treatment groups. These factors underscore the need for larger, prospective studies to confirm these findings and better characterize any differences between the treatments.
The study's principal investigators emphasize the significance of this first real-world comparison, noting that "more data are needed to confirm our results, with a larger study population to better evaluate any differences among these drugs."
