Abstract

Introduction: Switching biologics can improve efficacy without the impairment of safety in the treatment of psoriasis. Methods: In BE RADIANT, patients were randomized 1:1 to bimekizumab (BKZ) 320 mg every 4 weeks (wks)(Q4W) (Q4W or Q8W from Wk16) or secukinumab (SEC). Patients who completed the 48-wk double-blinded period could continue to the open label extension (OLE); all received BKZ 320 mg Q4W or Q8W through Wks48–96. We report efficacy for patients who switched from SEC to BKZ by Wk48 PASI90 response. Missing data were imputed as modified nonresponse. Patients who discontinued treatment due to lack of efficacy were considered nonresponders; multiple imputation was used for other missing data. Safety data are reported through Wks48–68 and Wks68–96. Results: At Wk48, 318 SEC-randomized patients continued to the OLE. 53 (16.7%) of these patients did not achieve PASI90. After switching to BKZ, responses improved (79.2% achieved PASI90 and 50.9% achieved PASI100 at Wk96). At Wk48, 256/318 (80.5%) SEC-randomized patients who entered the OLE achieved PASI90. Among these Wk48 PASI90 responders, 95.2% maintained PASI90 at Wk96. In SEC PASI90 responders, PASI100 response increased from 65.2% at Wk48 to 79.9% at Wk96. No clinically relevant differences in safety outcomes for patients who switched from SEC to BKZ were observed between Wks48–68 and Wks68–96. Conclusions: SEC PASI90 nonresponders demonstrated improvements in complete/near complete skin clearance after switching to BKZ. Among SEC PASI90 responders, PASI90 response was maintained and PASI100 response increased after switching. There were no unexpected safety findings in patients who switched.

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