Bimekizumab, Brodalumab Safe, Effective Up to 36 Weeks for Psoriasis

Bimekizumab (Bimzelx) and brodalumab (Siliq), 2 fast-acting IL-17 inhibitors for psoriasis, show significant clinical improvement, but how do they compare head-to-head?¹ A study of 125 patients found that bimekizumab led to higher Psoriasis Area Severity Index (PASI) 100 response rates at weeks 4 and 16, while brodalumab had a slightly higher discontinuation rate for ineffectiveness. Despite minor differences in safety outcomes, both treatments proved effective in reducing psoriasis severity.

Both drugs showed significant improvements, with higher responses observed for bimekizumab, study finds. | Image credit: SergeVo - stock.adobe.com

This retrospective study is published in Dermatology and Therapy.

“Currently, real-life data comparing the efficacy and safety profiles of bimekizumab and brodalumab to highlight eventual differences are still lacking,” wrote the researchers of the study. “Thus, the aim of our study was to indirectly compare the efficacy and safety of bimekizumab and brodalumab in patients with psoriasis, in a real-life setting.”

IL-17 inhibitors have emerged as a highly effective class of biologics for moderate to severe plaque psoriasis, targeting the inflammatory cytokines that drive the disease.² By blocking IL-17A, IL-17F, or the IL-17 receptor, these therapies provide rapid symptom relief and high skin clearance rates compared with other biologics. Among them, bimekizumab and brodalumab stand out for their unique mechanisms of action and fast onset, making them key contenders in psoriasis management.

In this study, patients were at least 18 years old, had a confirmed diagnosis of moderate to severe psoriasis, and had been treated with either drug for at least 16 weeks.¹ Baseline data collection included demographic characteristics, clinical history, and PASI and body surface area (BSA). Treatment response was evaluated at weeks 4, 16, and 36 based on PASI and BSA improvements, with PASI90 and PASI100 response rates recorded. Safety outcomes and treatment discontinuation were also assessed.

Of the 125 patients included in the study, 53 (42.4%) received bimekizumab and 72 (57.6%) received brodalumab. Baseline psoriasis severity was comparable between the 2 groups, and both treatments led to significant reductions in PASI and BSA scores at each follow-up.

However, bimekizumab demonstrated a higher PASI90 and PASI100 response rate at all timepoints, with PASI100 response being significantly greater compared with brodalumab at week 4 (41.5% vs 23.6%, P < .05) and week 16 (67.9% vs 48.6%). Discontinuation due to inefficacy was more frequent in the brodalumab group (8.3%) than in the bimekizumab group (3.8%), though this difference was not statistically significant.

Regarding safety, 2 cases of eczematous reactions occurred in the bimekizumab group, and 5 cases of candidiasis were reported (4 with bimekizumab, 1 with brodalumab). Overall, adverse event-related discontinuation was slightly higher with bimekizumab (5.7%) compared with brodalumab (1.4%).

However, the researchers acknowledged some limitations, including that the study was retrospective in design, had a limited number of patients in the study population, had a limited follow-up time, and had a different sample size between the study groups.

Despite these limitations, the researchers believe the study confirmed the efficacy and safety of bimekizumab and brodalumab up to 36 weeks, with bimekizumab showing better treatment response.

“To the best of our knowledge, this is the first study evaluating and comparing bimekizumab and brodalumab in real-life settings,” wrote the researchers. “Certainly, more data are needed to confirm our results, with a larger study population to better evaluate any differences among these drugs.”

References

1. Potestio L, Martora F, Raia F, et al. Indirect comparison between bimekizumab and brodalumab for the management of moderate to severe psoriasis: a 36-week real-life study. Dermatol Ther (Heidelb). Published online February 21, 2025. doi:10.1007/s13555-025-01361-x

2. Aggarwal P, Fleischer AB Jr. IL-17 and IL-23 inhibitors have the fastest time to meaningful clinical response for plaque psoriasis: a network meta-analysis. J Clin Med. 2024;13(17):5139. doi:10.3390/jcm13175139