Indirect Comparison Between Bimekizumab and Brodalumab for the Management of Moderate to Severe Psoriasis: A 36-Week Real-Life Study.

IF 3.5 3区医学 Q1 DERMATOLOGY

Dermatology and Therapy Pub Date : 2025-03-01 Epub Date: 2025-02-21 DOI:10.1007/s13555-025-01361-x

Luca Potestio, Fabrizio Martora, Flavia Raia, Gioacchino Lucagnano, Claudio Brescia, Ginevra Torta, Matteo Megna

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引用次数: 0

Abstract

Introduction: Bimekizumab and brodalumab are characterized by a different mechanism of action if compared to the other anti-interleukin (IL)-17s which target IL-17A. Indeed, brodalumab acts on IL-17RA whereas bimekizumab acts on IL-17A, IL-17F, and IL-17AF cytokines. Currently, despite real-life data on the efficacy and safety of bimekizumab and brodalumab have been reported, data comparing these two drugs are absent. However, these data are mandatory to evaluate whether a different target of the same IL can be correlated with a different profile in terms of effectiveness and safety. Moreover, it should be underlined that bimekizumab and brodalumab stood out as the psoriasis treatments with the fastest onset of action, delivering quicker therapeutic responses compared to other drugs acting on IL-17.

Methods: A monocentric retrospective study was carried out enrolling patients affected by moderate to severe psoriasis undergoing treatment with brodalumab or bimekizumab. At baseline, clinical demographic details were collected. Clinical improvement [Psoriasis Area Severity Index (PASI), body surface area (BSA)] was collected at weeks 4, 16, and 36. Safety data were analyzed at the same timepoints.

Results: A total of 125 patients were enrolled in the study [bimekizumab: 53 (42.40%); brodalumab: 72 (57.6%)]. Psoriasis severity at baseline was similar between the two cohorts. Both PASI and BSA significantly reduced at each follow-up for both treatment cohorts. The bimekizumab group reached a higher percentage of PASI90/PASI100 response at each timepoint as compared to the brodalumab cohort. In particular, the percentage of PASI100 response was significantly higher in the bimekizumab group as compared to the brodalumab cohort at week 4 (41.5% vs 23.6%, p < 0.05) and at week 16 (67.9% vs 48.6%). Discontinuation for ineffectiveness was higher in the brodalumab cohort (8.3%) as compared to the bimekizumab group (3.8%), without statistical significance. As regards safety, two cases of eczematous reactions (bimekizumab: 2, brodalumab: 0), and five cases of candidiasis (bimekizumab: 4, brodalumab: 1) were collected. Overall, 3 (5.7%) and 1 (1.4%) patients discontinued bimekizumab and brodalumab because of adverse events, respectively.

Conclusion: Our study confirmed the efficacy and safety of both bimekizumab and brodalumab, up to 36 weeks of treatment. Although both drugs showed a significant improvement of the investigated scores from week 4, some differences in terms of PASI90 and PASI100 responses (higher for bimekizumab at each follow-up, with only PASI100 response significantly higher at week 4 and 16) were registered. No statistical significance was found for safety data and treatment failure.

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Bimekizumab和Brodalumab治疗中重度牛皮癣的间接比较：一项为期36周的现实研究

与其他靶向IL- 17a的抗白介素(IL)-17相比，Bimekizumab和brodalumab具有不同的作用机制。事实上，brodalumab作用于IL-17RA，而bimekizumab作用于IL-17A， IL-17F和IL-17AF细胞因子。目前，尽管有关于bimekizumab和brodalumab的有效性和安全性的真实数据报道，但缺乏比较这两种药物的数据。然而，这些数据对于评估同一IL的不同靶点是否与不同的有效性和安全性相关是强制性的。此外，应该强调的是，比美珠单抗和布罗达鲁单抗作为银屑病治疗中起效最快的药物，与其他作用于IL-17的药物相比，提供更快的治疗反应。方法：一项单中心回顾性研究纳入了接受布罗达鲁单抗或比美珠单抗治疗的中重度牛皮癣患者。基线时，收集临床人口学细节。在第4周、第16周和第36周收集临床改善情况[牛皮癣区域严重指数（PASI）、体表面积（BSA）]。在同一时间点分析安全性数据。结果：共有125例患者入组研究[比美珠单抗：53例（42.40%）；Brodalumab: 72(57.6%)]。两组患者的牛皮癣严重程度基线相似。在两个治疗组的每次随访中，PASI和BSA均显著降低。比美珠单抗组在每个时间点的PASI90/PASI100应答百分比均高于博达鲁单抗组。特别是，在第4周时，比美珠单抗组的PASI100应答率明显高于brodalumab组（41.5% vs 23.6%, p）。结论：我们的研究证实了比美珠单抗和brodalumab的有效性和安全性，治疗时间长达36周。尽管从第4周开始，两种药物都显示出研究评分的显著改善，但在PASI90和PASI100反应方面存在一些差异（比美珠单抗在每次随访中更高，只有PASI100反应在第4周和第16周显著更高）。安全性数据和治疗失败无统计学意义。

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来源期刊

Dermatology and Therapy Medicine-Dermatology

CiteScore

6.00

自引率

8.80%

发文量

187

审稿时长

6 weeks

期刊介绍： Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.