The better understanding of the immunopathogenesis of
psoriasis has led to the development of highly efficacious targeted
therapies with favorable safety profiles. Among them, the class of
Interleukin (IL)-17
antibodies are well established for the treatment of
psoriasis,
psoriatic arthritis and
axial spondyloarthritis.
Bimekizumab is a new antibody that simultaneously neutralizes
IL-17A and
IL-17F. We present two patients with
psoriasis, who lost response to several biologics, among them
IL-17 antagonists such as
secukinumab,
ixekizumab or
brodalumab. Besides plaque-type
psoriasis, patients also had
psoriasis in hard-to-treat areas such as scalp and groins or
psoriatic arthritis. Remarkably, both patients already responded to the
therapy with
bimekizumab 4 weeks after the first injection and, one year thereafter, both patients sustained PASI100. No side effects were observed. The fast response to
bimekizumab emphasizes the crucial role of
IL-17F in the pathogenesis of
psoriasis. Besides, due to the new mechanism of action, non-responders to other anti-IL-17
therapies could benefit when switched to
bimekizumab.