Bimekizumab Durable Improvements in Psoriasis Over 3 Years in BE RADIANT Trial
In the BE RADIANT phase 3b trial, bimekizumab provided greater and durable improvements in patient-reported symptoms, skin clearance, and quality of life over 3 years compared with secukinumab in moderate to severe plaque psoriasis. At week 4, significantly more patients on bimekizumab achieved complete absence of itching, skin pain, and scaling. The benefits were sustained through 3 years, including after patients switched from secukinumab.
In the phase 3b BE RADIANT trial, bimekizumab treatment led to durable improvements in patient-reported outcomes and clinical measures over three years in patients with moderate to severe plaque psoriasis. The study, published in JAMA Dermatology, is the first phase 3 analysis to compare dual inhibition of interleukin (IL)-17A and IL-17F with IL-17A inhibition alone.
The multicenter, randomized, double-blind trial included an open-label extension (OLE). Patients were randomly assigned to receive bimekizumab (n=373) or secukinumab (n=370) for 48 weeks, followed by a 96-week OLE. At entry into the OLE, those originally on bimekizumab continued therapy (continuous bimekizumab cohort), while those on secukinumab switched to bimekizumab (secukinumab/bimekizumab cohort). By week 64, all patients were receiving bimekizumab every 8 weeks. Bimekizumab was given as 320 mg every 4 weeks initially, then every 4 or 8 weeks; secukinumab was given as 300 mg every 4 weeks.
At week 4, a greater proportion of patients in the bimekizumab group achieved complete symptom absence compared with secukinumab: absence of itching (34.0% vs 25.1%), skin pain (74.5% vs 60.0%), and scaling (46.1% vs 21.6%). These differences persisted at one year: pruritus absent in 60.9% vs 48.1% (nominal P<.001), no skin pain in 78.6% vs 70.8% (nominal P=.01), and no scaling in 70.5% vs 49.7% (nominal P<.001).
Simultaneous complete skin clearance (Psoriasis Area and Severity Index [PASI] = 0) and minimal quality-of-life impact (Dermatology Life Quality Index [DLQI] 0/1) was achieved more often with bimekizumab. At 4 weeks, 11.5% of bimekizumab patients vs 4.6% of secukinumab patients reached both endpoints (nominal P<.001); at 1 year, 61.7% vs 42.7% (nominal P<.001).
Among patients entering the OLE, high rates of complete symptom resolution on the Psoriasis Symptoms and Impacts Measure were sustained through 3 years. At OLE initiation, concurrent PASI=0 and DLQI 0/1 responses were present in 69.2% of continuous bimekizumab-treated patients and 48.5% of those switching from secukinumab. After switching to bimekizumab, response rates improved, and by year 3, similarly high proportions were maintained.
The findings indicate that bimekizumab may offer patient-reported and clinical benefits in moderate to severe plaque psoriasis, with durable improvements in symptoms, skin clearance, and quality of life.