Bimekizumab Outperforms Active Comparators in Clearing Skin, Nail Psoriasis

Bimekizumab therapy may lead to greater numbers of individuals attaining complete clearance of psoriasis across both skin and nails, compared with ustekinumab, adalimumab, and secukinumab, among patients with nail psoriasis at baseline, new data suggest.¹

These new findings highlighting bimekizumab’s efficacy among such patients were the result of a recent evaluation of concurrent nail clearance and complete skin clearance among those with moderate-to-severe plaque psoriasis who were treated with bimekizumab or active comparators. Joseph F. Merola, MD, MMSc, from the Department of Dermatology and Department of Medicine at UT Southwestern Medical Center, Dallas a team of investigators in conducting this analysis.

Merola and coauthors highlighted that approximately 1 of every 3 with psoriasis progress to psoriatic arthritis (PsA) over the course of their skin disease.² Consequently, they pointed to a need for understanding of nail disease among clinicians to improve the identification high risk patients who may see their disease progress to PsA.

“To evaluate the efficacy of bimekizumab in different domains of psoriatic disease at the same time, we assessed concurrent clearance of both skin and nails at any given timepoint post hoc in patients with moderate-to-severe plaque psoriasis treated with bimekizumab versus adalimumab, ustekinumab, and secukinumab during head-to-head phase III trials,” Merola et al wrote.¹

The investigative team’s analyses included findings from several different studies, including the phase 3 BE SURE and BE VIVID trials. The team also looked at these studies’ open-label extension study BE BRIGHT in addition to the phase 3b BE RADIANT trial and its extension phase.

Those who had taken part were adults living with moderate-to-severe plaque psoriasis, defined by baseline criteria of Psoriasis Area and Severity Index (PASI) ≥12 as well as ≥10% body surface area involvement, and an Investigator’s Global Assessment score ≥3 on a 5-point scale. Merola and colleagues would only evaluate individuals showing baseline nail involvement, determined by a modified Nail Psoriasis Severity Index (mNAPSI) score of >0, who proceeded into their respective extension studies.

The outcomes reported by the investigators were aimed at the proportion of patients who attained simultaneous clearance of their skin, determined through 100% Psoriasis Area and Severity Index score improvement from baseline (PASI 100) and clearance of their nails (mNAPSI 0). These data were presented for participants treated with bimekizumab compared with active comparators during the randomized trial phases, and for those on continuous bimekizumab therapy or switched from comparators at the time of the extension phases. The findings were analyzed using modified non-responder imputation.

Statistical analyses were highlighted by Merola and coauthors as descriptive in nature, and they were applied across all endpoints. These endpoints included those in the electronic supplementary material. There was no hypothesis testing conducted for post hoc assessments. During the conclusion of the comparator-controlled study periods, the investigative team determined that concurrent achievement of PASI 100 and mNAPSI 0 was seen in:

• 45.8% of individuals on bimekizumab (N = 151) compared with 18.3% treated with adalimumab (N = 91) by the 24-week mark in BE SURE
• 51.1% of individuals on bimekizumab (N = 169) compared with 26.5% treated with ustekinumab (N = 92) by the 52-week mark in BE VIVID
• 63.3% of individuals on bimekizumab (N = 182) compared with 36.1% treated with secukinumab (N = 155) by the 48-week mark in BE RADIANT

In their evaluation of those on long-term therapy, Merola et al found that the proportions of participants attaining both PASI 100 and mNAPSI 0 were shown to be:

• 57.7% of individuals who switched from adalimumab and 49.1% of those who were on continuous bimekizumab at by the 4-year mark in BE SURE/BE BRIGHT
• 52.2% of individuals who switched from ustekinumab and 48.3% of those maintained on bimekizumab at the 4-year mark in BE VIVID/BE BRIGHT
• 51.9% of individuals who switched from secukinumab and 57.4% of those on continuous bimekizumab at the 3-year mark in BE RADIANT

“Patients switching from comparators to bimekizumab demonstrated further improvement in skin and nail symptoms, and sustained complete clearance of both in the long term, similar to those continuously treated with bimekizumab,” Merola et al concluded.¹ “The ability of bimekizumab to treat multiple domains of psoriatic disease could be highly advantageous to patients with psoriasis who are candidates for systemic therapy.”

References

1. Merola JF, Warren RB, Gisondi P, et al. Bimekizumab Complete Clearance of Both Skin and Nail Psoriasis: Comparative Efficacy in Phase III/IIIb Studies. Am J Clin Dermatol. 2025 Aug 31. doi: 10.1007/s40257-025-00968-2. Epub ahead of print. PMID: 40886218.

2. Armstrong AW, Bohannan B, Mburu S, et al. Patient perspectives on psoriatic disease burden: results from the Global Psoriasis and Beyond Survey. Dermatology. 2023;239:621–34. Accessed September 4, 2025. https://doi.org/10.1159/000528945.