Hidradenitis suppurativa (HS) is a painful, inflammatory dermatosis involving recurrent abscesses, nodules and tunnels in intertriginous regions. Biologics and other immunomodulators have significantly expanded the treatment options available for HS. Bimekizumab is a monoclonal antibody targeting both interleukin-17A and interleukin-17F, key mediators of inflammation, that is already approved for psoriasis, psoriatic arthritis and axial spondylarthritis. It is currently pending FDA review for HS treatment but has already received marketing authorization for this indication in Europe. This review aims to explore drug-specific characteristics of bimekizumab including its mechanism of action, pharmacokinetics and pharmacodynamics and the current state of the literature regarding its use in HS such as safety, efficacy and dosing, while highlighting its implications in clinical practice. Recent Phase II and III trial data demonstrating positive efficacy and safety profiles in the treatment of HS will also be detailed.
Keywords: bimekizumab; biologics; hidradenitis suppurativa; hidradenitis suppurativa treatment; immunotherapy; inflammatory dermatoses; interleukin-17; pharmacokinetics.
What is this review about? Hidradenitis suppurativa (HS) is a skin condition that commonly causes painful abscesses, nodules, tunnels and scars with a predilection for areas of skinfolds like the underarms, under the breast and genital area. Multiple treatment options exist but none completely cure the disease. Treatments that target specific signals involved in the human immune system response are currently being used and developed for HS. Bimekizumab is an antibody-based treatment being considered for HS. It targets interleukin-17A and interleukin-17F (IL-17A/F), which are both involved in the inflammation in HS and other inflammatory conditions like psoriasis. In this review, we discuss how it works, its safety and its usefulness for the treatment of HS.What were the results? The available data show that bimekizumab is effective at treating the symptoms of moderate to severe HS by reducing the number of skin lesions and preventing new ones from developing in more patients compared with no medications. Additionally, it reduces pain from HS and improves patient quality of life at a higher level than a placebo medication. Bimekizumab was also found to be safe with few serious side effects. Common non-serious side effects included infections, gastrointestinal symptoms and headaches.What do the results mean for managing hidradenitis suppurativa? Bimekizumab is a viable treatment option for HS and may be considered in patients with moderate to severe HS if they have failed other treatment options. However, further research and long-term safety research is needed to support these recommendations.