Comparative efficacy and safety of bimekizumab in axial spondyloarthritis: a systematic literature review and network meta-analysis.

Abstract

OBJECTIVES:

To compare the efficacy and safety of bimekizumab 160 mg every 4 weeks, a selective inhibitor of IL-17F and IL-17A, with those of biologic/targeted synthetic DMARDs (b/tsDMARDs) in non-radiographic axial SpA (nr-axSpA) and AS.

METHODS:

A systematic literature review identified randomized controlled trials until January 2023 for inclusion in Bayesian network meta-analyses (NMAs), including three b/tsDMARDs exposure networks: predominantly-naïve, naïve, and experienced. Outcomes were Assessment of SpondyloArthritis international Society (ASAS)20, ASAS40 and ASAS partial remission (PR) response rates at 12-16 weeks. A safety NMA investigated discontinuations due to any reason and serious adverse events at 12-16 weeks.

RESULTS:

The NMA included 36 trials. The predominantly-naïve network provided the most comprehensive results. In the predominantly-naïve nr-axSpA analysis, bimekizumab had significantly higher ASAS20 response rates vs secukinumab 150 mg [with loading dose (LD)/without LD], and comparable response rates vs other active comparators. In the predominantly-naïve AS analysis, bimekizumab had significantly higher ASAS40 response rates vs secukinumab 150 mg (without LD), significantly higher ASAS-PR response rates vs secukinumab 150 mg (with LD) and comparable response rates vs other active comparators. Bimekizumab demonstrated similar safety to that of other b/tsDMARDs.

CONCLUSION:

Across ASAS outcomes, bimekizumab was comparable with most b/tsDMARDs, including ixekizumab, TNF inhibitors and upadacitinib, and achieved higher response rates vs secukinumab for some ASAS outcomes in predominantly b/tsDMARD-naïve nr-axSpA and AS patients at 12-16 weeks. In a pooled axSpA network, bimekizumab demonstrated comparable safety vs other b/tsDMARDs.

• Authors: Atul Deodhar, Pedro M Machado, Michael Mørup, Vanessa Taieb, Damon Willems, Michelle Orme, David Pritchett, Lianne S Gensler
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) Vol. 63 Issue 5 Pg. 1195-1205 (May 02 2024) ISSN: 1462-0332 [Electronic] England
• PMID: 37947318 (Publication Type: Journal Article, Systematic Review, Meta-Analysis, Research Support, Non-U.S. Gov't, Comparative Study)
• Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.

Chemical References

• bimekizumab
• Antirheumatic Agents
• Antibodies, Monoclonal, Humanized
• secukinumab
• Interleukin-17

Topics

• Humans
• Antirheumatic Agents (therapeutic use, adverse effects)
• Network Meta-Analysis
• Antibodies, Monoclonal, Humanized (therapeutic use, adverse effects)
• Treatment Outcome
• Axial Spondyloarthritis (drug therapy)
• Randomized Controlled Trials as Topic
• Interleukin-17 (antagonists & inhibitors)