OBJECTIVES: This network meta-analysis (NMA) assesses the efficacy of bimekizumab 160 mg/4 weeks (Q4W), a selective inhibitor of interleukin (IL)‑17F in addition to IL-17A, in non-radiographic axial spondyloarthritis (nr- axSpA) and ankylosing spondylitis (AS) compared with approved biologic/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs).

METHODS: A systematic literature review was conducted to identify trials up to April 2022 for inclusion in a Bayesian NMA. Tumor necrosis factor alpha (TNFα) inhibitors were pooled as a single class reference comparator. Efficacy outcomes at 12–16 weeks included Assessment of SpondyloArthritis International Society (ASAS)20, ASAS40, and ASAS partial remission (PR) response rates. Rankings of each treatment are expressed as surface under the cumulative ranking curve (SUCRA) values (higher values represent higher ranked treatments).

RESULTS: Thirty-three trials were included in the NMA (~90% of patients were b/tsDMARD-naïve). In nr-axSpA (N=10), bimekizumab was associated with significantly higher ASAS20 vs secukinumab 150 mg no loading dose (SEC150-no load) (odds ratio [OR] 2.18, 95% credible interval [CrI]: 1.13, 4.24) and secukinumab 150 mg loading dose (SEC150-load) (OR 2.31, 95%CrI: 1.20, 4.53). In nr-axSpA bimekizumab is one of the highest ranked treatments and ranked first of seven comparators for ASAS20 (SUCRA: 92%), first of six for ASAS PR (77%), and second of seven (76%) for ASAS40. In AS (N=24), ASAS40 was significantly higher with bimekizumab vs SEC150-no load (OR 1.60, 95%CrI: 1.00, 2.60), and ASAS PR was significantly higher with bimekizumab vs SEC150-load (OR 1.65, 95%CrI: 1.08, 2.51). Bimekizumab ranked third of seven comparators (79%) for ASAS PR, and fourth of eight for ASAS20 (57%) and ASAS40 (58%).

CONCLUSIONS: The results of this NMA demonstrate that at week 12–16 bimekizumab achieved higher response rates compared with SEC150 for several ASAS outcomes across the axSpA spectrum, and similar rates compared with other b/tsDMARDs.