The First Department of Internal Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Fukuoka, Japan.
UCB Pharma, Slough, UK.
Expert Rev Clin Immunol. 2024 Feb;20(2):155-168. doi: 10.1080/1744666X.2023.2277266. Epub 2024 Jan 21.
Interleukin (IL)-17A and IL-17F have overlapping roles in pro-inflammatory signaling and have been implicated in the pathogenesis of psoriatic disease. Bimekizumab is the first human monoclonal antibody to selectively inhibit IL-17F in addition to IL-17A. Bimekizumab has been studied in several phase II/III trials and has been approved for the treatment of patients with psoriatic arthritis (PsA) in the EU and UK.
A literature search identified clinical trials examining the efficacy and safety of bimekizumab for PsA, which were critically appraised.
Clinical trials of bimekizumab in PsA have demonstrated rapid and sustained treatment responses and depth of response across the multiple disease domains. High levels of efficacy were sustained to 152 weeks in phase IIb trials, and to 52 weeks in phase III trials. Bimekizumab was generally well tolerated. As expected, due to the role of IL-17 in the immune response to fungal pathogens, there was an increase in mild-to-moderate, localized fungal infections with bimekizumab treatment, very few of which led to discontinuation. Studies over longer time periods, with relevant comparators from the IL-17A inhibitor class, and real-world data will be important to further define the role of bimekizumab among currently available treatments for PsA. [Figure: see text].
白细胞介素 (IL)-17A 和 IL-17F 在促炎信号中具有重叠作用，并与银屑病发病机制有关。比美替尼单抗是第一种人源化单克隆抗体，除了抑制 IL-17A 外，还能选择性抑制 IL-17F。比美替尼单抗已在多项 II/III 期临床试验中进行了研究，并已在欧盟和英国获得批准用于治疗银屑病关节炎 (PsA) 患者。
对评估比美替尼单抗治疗 PsA 的疗效和安全性的临床试验进行了文献检索。
在 PsA 中进行的比美替尼单抗临床试验显示出快速和持续的治疗反应以及多个疾病领域的反应深度。在 IIb 期试验中，高疗效水平持续到 152 周，在 III 期试验中持续到 52 周。比美替尼单抗通常具有良好的耐受性。由于 IL-17 在针对真菌病原体的免疫反应中的作用，与比美替尼单抗治疗相关的轻度至中度、局部真菌感染有所增加，但很少导致停药。在更长的时间段内进行研究，与来自 IL-17A 抑制剂类别的相关对照药物，并获得真实世界的数据，对于进一步确定比美替尼单抗在目前可用的 PsA 治疗方法中的作用将非常重要。[图：见正文]。
