Bimekizumab demonstrates overall greater efficacy than guselkumab in psoriatic arthritis patients at 52 weeks, according to an analysis of data from several trials.
Approximately 30% of psoriasis patients develop psoriatic arthritis (PsA). Recent Phase 3 trials have demonstrated the efficacy and safety of bimekizumab (an interleukin-17F and IL-17A inhibitor) and guselkumab (an interleukin-23 inhibitor) in PsA patients.
A literature review and analysis published in Rheumatology and Therapy compared the efficacy of bimekizumab to that of guselkumab at 52 weeks for treating PsA patients who were either naïve to biologic disease-modifying antirheumatic drugs (bDMARD-naïve) or had a previous inadequate response or intolerance to tumor necrosis factor inhibitors (TNFi-IR).
Study Method and Population
For bDMARD-naïve patients, individual patient data from the BE OPTIMAL trial (bimekizumab 160 mg every 4 weeks (Q4W): n = 431) was matched to summary data from the DISCOVER-2 trial (guselkumab 100 mg (Q4W): n = 245, guselkumab 100 mg every 8 weeks (Q8W): n = 248). For TNFi-IR patients, individual patient data from the BE COMPLETE/BE VITAL trials (bimekizumab 160 mg Q4W: n = 267) was matched to summary data from the COSMOS trial (guselkumab 100 mg Q8W: n = 189).
Bimekizumab Outperforms Guselkumab Q4W in Bdmard-Naïve Patients
Using matching-adjusted indirect comparisons (MAICs), bDMARD-naïve patients from BE OPTIMAL were matched to patients from DISCOVER-2. The post-matching effective sample sizes (ESSs) for bimekizumab were 155.08 (36% of the original sample size) for comparison to guselkumab Q4W and 142.04 (33% of OSS) for comparison to guselkumab Q8W.
In comparison to guselkumab Q4W, bimekizumab demonstrated a greater likelihood of achieving an American College of Rheumatology score of 50 (ACR50) (odds ratio (OR): 1.62, 95% confidence interval (CI): 1.07–2.44, p = 0.021), ACR70 (OR: 2.20, 95% CI: 1.43–3.38, p<0.001), and minimal disease activity (MDA) (OR: 1.82, 95% CI: 1.20–2.76, p = 0.005) responses and was comparable in achieving ACR20 (OR: 1.09, 95% CI: 0.68–1.74, p = 0.734) response at week 52.
Bimekizumab Demonstrates Greater Efficacy Than Guselkumab Q8W
In comparison to guselkumab Q8W, bimekizumab demonstrated a greater likelihood of achieving ACR70 (OR: 2.08, 95% CI: 1.34–3.22, p = 0.001) and MDA (OR: 2.07, 95% CI: 1.35–3.17, p<0.001) responses and was comparable in achieving ACR20 (OR: 0.86, 95% CI: 0.53–1.40, p = 0.548) and ACR50 (OR: 1.38, 95% CI: 0.90–2.09, p = 0.135) responses at week 52.
Bimekizumab Superior to Guselkumab Q8W in All TNFi-IR Efficacy Outcomes
Using MAIC, patients who were TNFi-IR from BE COMPLETE/ BE VITAL were matched to patients from COSMOS. The post-matching ESS for bimekizumab was 180.84 (67.7% of OSS).
In comparison to guselkumab Q8W, bimekizumab demonstrated a greater likelihood of achieving ACR20 (OR: 1.77, 95% CI: 1.15–2.72, p = 0.010), ACR50 (OR: 1.56, 95% CI: 1.03–2.36, p = 0.037), ACR70 (OR: 1.66, 95% CI: 1.05–2.61, p = 0.028), and MDA (OR: 1.95, 95% CI: 1.27–3.02, p = 0.003) responses at week 52. The adjusted odds ratios for both treatments were similar to the unadjusted odds ratios for all outcomes, further validating these findings.
Source:
Bandyopadhyay, D., McInnes, I. B., Nash, P., Grouin, J., Lyris, N., Willems, D., Taieb, V., Eells, J., & Mease, P. J. (2024). Comparative Effectiveness of Bimekizumab and Guselkumab in Patients with Psoriatic Arthritis at 52 Weeks Assessed Using a Matching-Adjusted Indirect Comparison. Rheumatology and Therapy. https://doi.org/10.1007/s40744-024-00659-0
