Predictive factors of early super-response in patients with psoriasis treated with bimekizumab

Bimekizumab, an IL-17A/F inhibitor, has shown promising efficacy and safety in clinical trials and real-world studies of patients with psoriasis. Continual improvements in skin clearance with biologics has led to efforts to identify “super-responders,” which would allow dermatologists to determine characteristics of patients who may respond better to a specific biological therapy.

A retrospective study examined bimekizumab efficacy and safety in 109 patients with plaque psoriasis in two centers in Italy. Efficacy was measured by achievement of PASI 75/90/100, with early super-response defined as achievement of PASI 100 at Week 4. Results were published by Fratton et al. in Psoriasis (Auckland).

Key learnings

Bimekizumab showed rapid and sustained efficacy in this patient population. By Week 4, 28.4% of patients achieved PASI 100; this increased to 72.1% by Week 48.

Early super-response (ESR) was achieved by 28.4% of patients. Predictors of ESR included lower baseline PASI (OR: 0.93, p = 0.029), absence of nail involvement (OR: 0.12, p = 0.003), and fewer prior biologic therapy failures (OR: 0.14, p = 0.038).

15.6% of patients experienced AEs. The most common were candidiasis (7.3%) and eczema (4.6%). Asthma and/or allergic rhinitis significantly increased the risk of AEs (p = 0.012).

Early identification of ESR predictors can support precision medicine by enabling more individualized therapeutic decisions. Likewise, recognizing patients at elevated AE risk may improve monitoring and prevention strategies.