Bimekizumab versus Adalimumab in Plaque Psoriasis
Welcome to the channel today we’ll be summarizing the results of the visual study published in a new england journal medicine on july 8 and presented in the american academy of dermatology virtual meeting experience in april 2021. psoriasis is a common chronic inflammatory skin condition affecting men and women of all ages and races signs and symptoms vary but
Skin lesions of the most common subtype plug psoriasis are classically described as salmon pin packages covered with silvery scales mainly over the scalp elbows knees and gluteal cleft the condition occasionally involves other areas including the nails and joints nearly three percent of the world’s population are living with psoriasis approximately 125 million
Patients as with many skin conditions psoriasis has a considerable psychological impact on quality of life potentially affecting personal and professional relationships including social life and sexual functioning multiple scoring systems have been validated to evaluate the severity of psoriasis including parsi and iga scores the psoriasis area and severity
Index or pessi is scored by rating the severity from 0 to 4 of redness thickness and scaling over the body’s four main regions and multiplying it by the affected body surveys area to derive aggregate score which can range from 0 to 72 with higher scores indicating worser disease a passive score exceeding 10 is generally taken to be moderate to severe disease
In comparison the investigator’s global assessment score or iga is a simpler grading system that visually classifies psoriatic disease into a five point scale treatment of psoriasis generally depends on its severity for limited disease topicals are usually the therapy of choice in moderate to severe disease dermatologists turn to phototherapy or systemic
Agents such as retinoids and methotrexate in recent years the arsenal has been supplemented by biologic agents such as adali mumbai a tumor necrosis factor inhibitor that directly targets the pathophysiological processes underlying the disease the makizumab is an investigational humanized monoclonal iggy antibody that selectively and directly inhibits both
Interleukin-17a and 17f two key cytokines driving the inflammatory processes il-17f has overlapping biology of il17a and drives inflammation independently of il-17a selective inhibition of il-17f in addition to il-17a has been shown to suppress inflammation to a greater extent than il-17ae episode low ucb from biopharma a pharmaceutical company headquartered
In belgium developed this drug and has funded multiple investigational studies to study safety and efficacy including b schwa and his other sister charles be ready be radiant and be vivid be sure was designed to evaluate the safety and efficacy of magnezumab compared to a dali moment in reducing the signs and symptoms of plug psoriasis this was designed to be
Both a non-inferiority and superiority trial this was a phase three multi-center double-blind randomized control trial conducted over 56 weeks involving 478 participants with moderate to severe plux psoriasis with a mean baseline pisces score of 19.8 they will equally split into three groups one received monthly injections of bimekizumab and another received
Bi-weekly adaling map injections for half a year before getting monthly bimekizuma injections and the last had monthly bimanizumab injections for four months before transitioning to a bi-monthly regime primary outcomes were firstly 90 or greater reduction from baseline in the passive score or the passing id response and secondly an iga score of 0 to 1 signifying
Clear or almost clear skin the non-inferiority margin was fixed at 10 before testing for superiority other outcomes included the rate of adverse events as well as parsi and iga responses at various other time points besides week 16 and here are the results nearly 40 percent more patients on pure beam mechizumab regimes achieved a 90 reduction in passive score
Compared to those given at the darling moment and about 30 percent more patients attain the desirable iga score on a single agent compared to a mixed regime both outcomes met statistical significance for both non-inferiority and superiority the rate of adverse events serious or otherwise was similar between the different regimens the most common adverse events
For bimekizumab were urtis oral thrush hypertension and diarrhoea all were relatively manageable and generally not of great clinical concern this study shows that bibenki zuma led to significant improvement in patients with moderate to severe plaque psoriasis while maintaining a reasonable safety and tolerability profile this also highlights the viability of
Dual ir17a and 17f inhibitors in the treatment of psoriasis there are however many caveats firstly this study did not directly compare pure adalimumab regime with a pure bimechisma amygd by instead formulated mixed regime containing both drugs this can potentially obscure the individual effects of each drug on the safety and efficacy analysis in a similar vein
Combining both bimakizuman regimes during the statistical analysis may also dilute the findings for example one regimen could have been more efficacious but led to greater side effects by analyzing the data together with another regimen there’s less applications but more tolerable it could dampen the results in both aspects a 56-week follow-up period was also
Relatively short and 500 participants also a relatively small sample size for study on such a common condition the authors also acknowledge these limitations in their paper lastly as a trial selected for participants with moderate to severe disease we are unable to generalize the results to a lower risk population however given that biologics are only considered
For patients with severe disease who have failed in other therapy this may not matter so much in actual clinical practice hope you’ve learned something from this video please like and subscribe for more such videos thank you
Transcribed from video
Bimekizumab vs Adalimumab in Plaque Psoriasis (BE SURE) | NEJM | Med Journal Club By Med Journal Club