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Bimekizumab for treating moderate to severe plaque psoriasis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Bimekizumab for treating moderate to severe plaque psoriasis

NICE guidance states (1):

  • Bimekizumab alone or with methotrexate, is recommended as an option for treating active psoriatic arthritis (defined as peripheral arthritis with 3 or more tender joints and 3 or more swollen joints) in adults whose condition has not responded well enough to disease-modifying antirheumatic drugs (DMARDs) or who cannot tolerate them. It is recommended only if they have had 2 conventional DMARDs and:
    • at least 1 biological DMARD or
    • tumour necrosis factor (TNF)-alpha inhibitors are contraindicated but would otherwise be considered
  • assess response to bimekizumab after 16 weeks of treatment
    • stop bimekizumab if the psoriatic arthritis has not responded adequately using the Psoriatic Arthritis Response Criteria (PsARC; an adequate response is an improvement in at least 2 of the 4 criteria, 1 of which must be joint tenderness or swelling score, with no worsening in any of the 4 criteria)
    • if the PsARC response is not adequate but there is a Psoriasis Area and Severity Index (PASI) 75 response, a dermatologist should decide whether continuing treatment is appropriate based on skin response
  • take into account how skin colour could affect the PASI score and make any adjustments needed

For more detailed guidance see NICE (October 2023). Bimekizumab for treating active psoriatic arthritis


  • bimekizumab is a humanized monoclonal IgG1 antibody
    • mechanism of action (dual inhibition of IL-17A and IL-17F) (2,3)
      • selectively neutralizes both IL-17A and IL-17F
      • along with IL-17A, IL-17F can also cooperate with tumor necrosis factor-alpha (TNF-alpha) in inducing the production of key pro-inflammatory keratinocyte mediators (3)
      • mechanism of action allows a more extensive suppression of disease inflammation, with a greater reduction of gene expression, migration of inflammatory cells and production of proinflammatory cytokines than the isolated blockade of IL-17A (2)
      • bimekizumab has no activity on IL-17E (thought to have anti-inflammatory properties), unlike the IL-17RA inhibitor brodalumab (2)
    • is considered a new therapeutic approach for the treatment of moderate-to-severe psoriasis (2)
    • bimekizumab has demonstrated superiority in all direct comparative clinical trials conducted, whether against ustekinumab (IL-12/23 inhibitor), adalimumab (TNF inhibitor) or secukinumab (IL-17A inhibitor), for the treatment of psoriatic arthritis (2)


  • NICE (October 2023). Bimekizumab for treating active psoriatic arthritis
  • Freitas E, Torres T. Bimekizumab: the new drug in the biologics armamentarium for psoriasis. Drugs Context. 2021;10:2021-4-1.
  • Chiricozzi A, De Simone C, Fossati B, Peris K. Emerging treatment options for the treatment of moderate to severe plaque psoriasis and psoriatic arthritis: evaluating bimekizumab and its therapeutic potential [published correction appears in Psoriasis (Auckl). 2019 Aug 15;9:73-74]

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