Indirect comparison of bimekizumab vs brodalumab for plaque psoriasis

Bimekizumab and brodalumab are IL-17 inhibitors, with distinct mechanisms of action.¹ Bimekizumab targets IL-17A, IL-17F, and IL-17AF, while brodalumab has a high affinity for IL-17RA. Both treatments have shown efficacy in treating moderate-to-severe plaque psoriasis, and are approved by the FDA in this indication. However, there are limited data comparing the two treatments.¹

A single-center, retrospective study indirectly compared the efficacy and safety of bimekizumab and brodalumab in 125 adult patients with moderate-to-severe plaque psoriasis.¹ Clinical improvement data (PASI and BSA) and safety data were collected at Weeks 4, 16, and 36. Results were published in Dermatology and Therapy by Potestio et al.¹.

Key learnings

Both therapies significantly reduced PASI and BSA scores from Week 4. The mean PASI score was reduced from 18.1 at baseline to 0.6 at Week 38 in the bimekizumab group and from 16.8 to 1.0 in the brodalumab group.

PASI100 response was significantly higher with bimekizumab vs brodalumab at Week 4 (41.5% vs 23.6%) and Week 16 (67.9% vs 48.6%). The incidence of candidiasis was numerically but not significantly higher in the bimekizumab group (7.5% vs 1.4%).

Discontinuation due to inefficacy was more frequent with brodalumab (8.3%) vs bimekizumab (3.8%). Conversely, discontinuation due to AEs was higher for bimekizumab (5.7%) vs brodalumab (1.4%).

Although both treatments are effective for psoriasis, bimekizumab may offer a higher response rate, with further comparator studies needed for confirmation. Treatment choice should be personalized based on patient response, tolerability, comorbidities, and consideration of treatment AE profiles.