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Axial Spondyloarthritis
Published in Jason Liebowitz, Philip Seo, David Hellmann, Michael Zeide, Clinical Innovation in Rheumatology, 2023
As of this text’s writing, there are eight FDA-approved therapies for treatment of axSpA in the United States: five TNF inhibitors, two IL-17 inhibitors, and one JAK inhibitor. In the near term, it is anticipated that several agents may gain regulatory approval. The IL17 pathway is likely to further expand, with promising data at this time for bimekizumab, a combined IL17 A/F inhibitor, and ongoing trials of brodalumab, an IL17A inhibitor. JAK inhibition is another likely fertile area, with promising data for efficacy of tofacitinib, upadacitinib, and filgotinib. However, filgotinib has been abandoned in the United States as of this writing due to concerns for testicular toxicity and reduced sperm counts.109 Elucidating how these agents are acting in AxSpA may help guide future therapeutics.
Targeting IL-23/IL-17 Axis for Treatment of Psoriasis and Psoriatic Arthritis
Published in Siba P. Raychaudhuri, Smriti K. Raychaudhuri, Debasis Bagchi, Psoriasis and Psoriatic Arthritis, 2017
Subhashis Banerjee, Philip Mease
Data from a Phase 1 single ascending dose study of IV bimekizumab in patients with mild to moderate psoriasis were reported recently [40]. Efficacy was remarkable in this trial, with complete skin clearance seen within 6 weeks with a single IV dose of 160–640 mg, with efficacy extending to around 16 weeks. A differentiating feature of bimekizumab from anti-IL-17A antibodies appears to be the durability of response—relapse occurs within 4–8 weeks of IL-17 mAb treatment withdrawal in psoriasis, while bimekizumab produced responses that lasted for at least 10 weeks after a single dose in this small study. The result of this dual targeting approach appears to be similar or show even greater efficacy than that with IL-17A blockade, but with a rapid and durable response resembling that with IL-23 mAbs. It is unclear why bimekizumab efficacy appears to be so much more durable, at least from this small study. Doses up to 640 mg in this trial were tested with a largely unremarkable safety profile.
Biologic therapies in the pipeline
Published in M. Alan Menter, Caitriona Ryan, Psoriasis, 2017
Molly Campa, Pablo Michel, Caitriona Ryan
Bimekizumab (UCB 4940) is an anti-IL-17A/F humanized monoclonal antibody with phase I trials completed in both psoriasis and psoriatic arthritis.20,21 The molecule is currently undergoing phase II trials, including the add-on use of bimekizumab to certolizumab-pegol in rheumatoid arthritis patients and another study in chronic plaque psoriasis.22,23 Results from these studies are pending.
Bimekizumab treatment in patients with moderate to severe plaque psoriasis: a drug safety evaluation
Published in Expert Opinion on Drug Safety, 2023
Angelo Ruggiero, Luca Potestio, Fabrizio Martora, Alessia Villani, Rosita Comune, Matteo Megna
Bimekizumab is a humanized monoclonal immunoglobulin (Ig)G1 antibody that acts by neutralizing both IL-17A and IL-17F [15,16]. It is administered through subcutaneous (SC) injections according to the following scheme: 320 mg (given as 2 subcutaneous injections of 160 mg each) at week 0, 4, 8, 12, 16, and every 8 weeks thereafter [22]. The mechanism of action of bimekizumab consists in binding with high affinity to IL-17A, IL-17F, and IL-17AF cytokines, avoiding their interaction with the IL-17RA/IL-17RC receptor complex [22]. Elevated concentrations of both IL-17A and IL-17F have been shown to play a central role in the pathogenesis of plaque psoriasis. Bimekizumab action, by inhibiting the action of these proinflammatory cytokines, results in the reduction of skin inflammation and, consequently in a significant improvement of psoriatic manifestations. Moreover, bimekizumab was shown to be able to inhibit psoriasis-related gene expression and cytokine production to a greater extent than inhibition of IL-17A alone [22,23].
Bimekizumab for the treatment of psoriatic disease
Published in Expert Opinion on Biological Therapy, 2018
Nicola E. Natsis, Alice B. Gottlieb
Bimekizumab is a systemic biologic that is currently in phase III clinical trials for the treatment of moderate-to-severe plaque psoriasis. Bimekizumab is a bispecific agent that targets both IL-17A and IL-17F. Interest in IL-17 inhibition began with the inhibition of IL-17A after it was discovered to be a driver of inflammation of psoriatic disease [10,11]. IL-17A and IL-17F have been implicated as drivers of chronic inflammation in autoimmune diseases, including arthritis in which they promote bone and cartilage erosion [12]. In order to achieve higher efficacy in psoriasis and PsA, there is a desire to further investigate ways to more completely dismantle the IL-17 family’s cytokine pathway and downstream effectors.
Antibodies to watch in 2022
Published in mAbs, 2022
Hélène Kaplon, Alicia Chenoweth, Silvia Crescioli, Janice M. Reichert
On August 20, 2021, the EC authorized marketing of Bimzelx (bimekizumab) in the EU for the treatment of moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy. Bimekizumab is a humanized IgG1ҡ antibody that selectively inhibits IL-17A and IL-17 F by binding regions common to these pro-inflammatory cytokines, which share ~50% sequence identity and are expressed as homodimers and IL-17A/F heterodimers. Bimekizumab is approved at a recommended dose of 320 mg, administered by two SC injections every 4 weeks to week 16 and every 8 weeks thereafter.55