OBJECTIVES: Bimekizumab is a monoclonal IgG1 antibody that selectively inhibits interleukin (IL)-17A and IL-17F. The objective was to perform a network meta-analysis (NMA) to assess the relative short-term clinical efficacy of bimekizumab versus other approved treatments for plaque psoriasis (PSO).

METHODS: A systematic literature review (SLR) was carried out in July 2020 to identify randomized controlled trials of biologics (anti-IL-17, anti-IL-23, anti-IL-12/23, anti-tumor necrosis factor [TNF] alpha), small molecules and conventional systemic agents. Results from four phase 3/3b trials of bimekizumab in PSO (not identified by the SLR) were included. The key efficacy measure was PASI (Psoriasis Area Severity Index), expressed as the proportion of patients achieving a x% reduction from baseline to the primary endpoint of included studies (which ranged between 10-16 weeks). A Bayesian multinomial probit baseline risk-adjusted random effects model with no assumption that all treatments ranked the same across PASI response levels was used. Treatment ranks were based on the surface under the cumulative ranking curves (SUCRAs).

RESULTS: 85 studies and 23 comparators were included in the NMA. Bimekizumab was the highest ranked treatment for PASI75, PASI90 and PASI100, with response probabilities of 92.9%, 85.1% and 59.5% respectively. Risankizumab and ixekizumab were the next best ranked treatments for PASI75 (PASI75: 90.0% and 90.1%; PASI90: 73.3% and 72.9%; PASI100: 42.5% and 40.6%, respectively). Bimekizumab had a higher response rate than all other treatments for PASI90 and PASI100, with an average probability of being better than every other comparator of greater than 99.9%.

CONCLUSIONS: This NMA indicated bimekizumab was the highest ranked treatment in terms of efficacy. Estimated PASI response rates were consistent with observed phase 3 clinical trial data; these data confirm the potential utility of bimekizumab for the treatment of moderate to severe PSO.