OBJECTIVES: To compare the efficacy of bimekizumab 160mg and secukinumab 150-mg (SEC150) and 300-mg (SEC300) at 52 weeks (Wk52) for the treatment of psoriatic arthritis (PsA) using matching-adjusted indirect comparisons (MAICs).

METHODS: Relevant trials were systematically identified. Individual patient data from BE OPTIMAL (N=431) and BE COMPLETE (N=260) were matched to aggregated data from biologic disease-modifying anti-rheumatic drug-naïve (bDMARD-n) and tumor necrosis factor inhibitor-experienced (TNFi-exp) subgroups from FUTURE 2 for SEC150 and SEC300 (bDMARD-n: N=63/37; TNFi-exp: N=67/33). To account for cross-trial differences in baseline characteristics, logistic regression for age, sex, Health Assessment Questionnaire-Disability Index, percentage with psoriasis affecting ≥3% body surface area, swollen and tender joint counts, and methotrexate use was used; adjustment variables were selected based on expert consensus (n=5). Unanchored comparisons of recalculated bimekizumab and SEC Wk52 outcomes for American College of Rheumatology (ACR) 20/50/70 and minimal disease activity (MDA) index non-responder imputation outcomes were reported as odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: In bDMARD-n patients, bimekizumab (effective sample size [ESS]=236) had a significantly greater likelihood of ACR70 response at Wk52 than SEC150 (OR [95% CI]: 2.39 [1.26, 4.53; p=0.008] and SEC300 (2.03 [1.11, 3.72; p=0.021]). In TNFi-exp patients at Wk52, bimekizumab (ESS=146) had a significantly greater likelihood of response than SEC150 for ACR20 (3.50 [1.64–7.49]), ACR50 (3.32 [1.41, 7.80; p=0.001]), ACR70 (2.95 [1.08, 8.07; p=0.035]) and MDA (3.52 [1.38, 8.99; p=0.009]), and greater than SEC300 for ACR50 (2.44 [1.06, 5.65; p=0.037]) and MDA (2.92 [1.20, 7.09; p=0.018]). All other analyses were non-significant.

CONCLUSIONS: The MAICs suggested bimekizumab to have greater likelihood of long-term response than SEC150 and SEC300 on most outcomes in patients with PsA, regardless of their prior bDMARD exposure. These results are consistent with a recent NMA where bimekizumab ranked higher than SEC for ACR and MDA outcomes at Wk16 to 24.