Shi Vivian Y, Ingram John R, Lev-Tov Hadar, Schneider-Burrus Sylke, Forman Seth, Porter Martina L, Hayama Koremasa, Thorlacius Linnea, Lambert Jérémy, Vaux Tom, Lukowski Bartosz, Rolleri Robert L, Szepietowski Jacek C
Department of Dermatology, University of Washington, Seattle, WA, USA.
Department of Dermatology and Academic Wound Healing, Division of Infection and Immunity, Cardiff University, Cardiff, UK.
Dermatol Ther (Heidelb). 2025 Jul 13. doi: 10.1007/s13555-025-01465-4.
Hidradenitis suppurativa (HS) symptoms (pain, itch, odour and drainage) impair quality of life (QoL). Bimekizumab, a humanised IgG1 monoclonal antibody, selectively inhibits interleukin (IL)-17A and IL-17F. The impact of bimekizumab on patient-reported outcomes (PROs) was assessed using pooled 48-week data from BE HEARD I&II (BHI&II) studies in moderate to severe HS.
Patients received (initial/maintenance) bimekizumab 320 mg every 2 weeks (Q2W)/Q2W, bimekizumab Q2W/Q4W, bimekizumab Q4W/Q4W or placebo/bimekizumab Q2W. HS Symptom Daily Diary (HSSDD) and HS Symptom Questionnaire (HSSQ) captured HS-specific patient-reported symptoms; HS Quality of Life questionnaire (HiSQOL) and Dermatology Life Quality Index (DLQI) captured health-related QoL (HRQoL). Change from baseline (CfB) and proportions of patients achieving clinically meaningful improvement thresholds or low disease impact are reported to Week 48 (observed case).
Of 1014 randomised patients, 868 received bimekizumab and 146 placebo. Greater numerical reductions at Week 16 were observed across HSSDD/HSSQ scores with bimekizumab vs placebo. From Week 16 to 48, HSSQ scores further numerically reduced with continuous bimekizumab and substantially reduced for placebo/bimekizumab switchers. At Week 16, bimekizumab showed numerically greater improvement in HRQoL vs placebo (HiSQOL total score mean CfB: - 11.7 to - 10.3 vs - 5.5). HiSQOL response rate (21-point total score reduction) was numerically higher by Week 4 in bimekizumab-treated patients (17.2-21.4%) vs placebo (9.2%); rates increased to Week 48 with continuous bimekizumab (42.0-47.4%) and in switchers (55.0%). Patients with very severe disease impact (HiSQOL total score ≥ 24) decreased over time with bimekizumab. At Week 16, DLQI minimal clinically important difference (4-point decrease) achievement was numerically greater with bimekizumab vs placebo (54.9-64.6% vs 49.1%). Achievement increased to Week 48 and switchers attained similar proportions (63.5-74.5% vs 76.5%). Comparable trends were observed for DLQI score of 0/1 (no HRQoL impact) achievement rates.
Bimekizumab demonstrated clinically meaningful improvements by Week 4 in HRQoL, which were maintained over 1 year across PROs in patients with moderate to severe HS. Graphical Abstract available for this article.
NCT04242446; NCT04242498.
化脓性汗腺炎(HS)的症状(疼痛、瘙痒、异味和渗液)会损害生活质量(QoL)。比美吉珠单抗是一种人源化IgG1单克隆抗体,可选择性抑制白细胞介素(IL)-17A和IL-17F。使用BE HEARD I&II(BHI&II)研究中关于中度至重度HS患者的48周汇总数据,评估了比美吉珠单抗对患者报告结局(PROs)的影响。
患者接受(初始/维持)每2周一次(Q2W)/Q2W的320mg比美吉珠单抗、Q2W/Q4W的比美吉珠单抗、Q4W/Q4W的比美吉珠单抗或安慰剂/Q2W的比美吉珠单抗治疗。HS症状每日日记(HSSDD)和HS症状问卷(HSSQ)记录了HS特异性患者报告的症状;HS生活质量问卷(HiSQOL)和皮肤病生活质量指数(DLQI)记录了与健康相关的生活质量(HRQoL)。报告了至第48周(观察病例)相对于基线的变化(CfB)以及达到具有临床意义的改善阈值或疾病影响较低的患者比例。
在1014例随机分组的患者中,868例接受了比美吉珠单抗治疗,146例接受了安慰剂治疗。与安慰剂相比,比美吉珠单抗治疗组在第16周时HSSDD/HSSQ评分的数值降低幅度更大。从第16周到第48周,持续使用比美吉珠单抗的患者HSSQ评分进一步降低,而从安慰剂转换为比美吉珠单抗的患者HSSQ评分大幅降低。在第16周时,比美吉珠单抗治疗组的HRQoL改善程度在数值上高于安慰剂组(HiSQOL总分平均CfB:-11.7至-10.3对比-5.5)。在接受比美吉珠单抗治疗的患者中,到第4周时HiSQOL反应率(总分降低21分)在数值上高于安慰剂组(17.2-21.4%对比9.2%);持续使用比美吉珠单抗的患者反应率在第48周时升至42.0-47.4%,转换治疗的患者反应率为55.0%。随着时间推移,比美吉珠单抗治疗组中疾病影响非常严重(HiSQOL总分≥24)的患者数量减少。在第16周时,比美吉珠单抗治疗组达到DLQI最小临床重要差异(降低4分)的比例在数值上高于安慰剂组(54.9-64.6%对比49.1%)。该比例在第48周时上升,转换治疗的患者达到了相似比例(63.5-74.5%对比76.5%)。对于DLQI评分为0/1(对HRQoL无影响)的达成率也观察到了类似趋势。
比美吉珠单抗在第4周时就显示出对HRQoL具有临床意义的改善,在中度至重度HS患者的整个PROs中这种改善持续了1年。本文提供了图形摘要。
NCT04242446;NCT04242498。