Improvements in itching, pain, scaling and overall quality of life occur rapidly with bimekizumab and remain durable for up to three years in patients with moderate-to-severe plaque psoriasis, according to a recent study.

The international analysis of data from the phase 3b BE RADIANT trial and its subsequent open-label extension assessed patient-reported outcomes (PROs) associated with bimekizumab therapy and examined how improvements in clinical disease activity translated into benefits for patients with plaque psoriasis.

BE RADIANT was conducted across multiple international centres and initially compared bimekizumab, a dual interleukin-17A and interleukin-17F inhibitor, with the interleukin-17A inhibitor secukinumab.

During the initial 48-week double-blind phase, 743 adults with moderate-to-severe plaque psoriasis were randomly allocated to receive either bimekizumab (n=373) or secukinumab (n=370).

After completing this phase, patients became eligible to enter a 96-week open-label extension in which all participants received bimekizumab. A total of 654 participants entered the open-label extension, comprising 336 patients from the original bimekizumab group and 318 who had initially received secukinumab in the double-blind phase before switching to bimekizumab.

Rapid improvements in psoriasis symptoms and PROs

Improvements in PROs were observed soon after treatment initiation. By week four, a greater proportion of patients receiving bimekizumab reported complete relief from itching compared with those treated with secukinumab (34.0% vs 25.1%).

A higher proportion of patients in the bimekizumab group also reported no skin pain (74.5% vs 60.0%) and no skin scaling (46.1% vs 21.6%). These early improvements in key symptoms were accompanied by improvements in health-related quality of life.

The benefits of bimekizumab persisted throughout the first year of treatment. At week 48, 60.9% of patients receiving bimekizumab reported no itching compared with 48.1% of those receiving secukinumab (P < 0.001).

Absence of skin pain was reported by 78.6% of patients in the bimekizumab group and 70.8% in the secukinumab group (P = 0.01). In addition, 70.5% of patients treated with bimekizumab reported no skin scaling compared with 49.7% of those receiving secukinumab (P < 0.001).

Clinical indicators of disease control aligned with these patient-reported improvements. Concurrent achievement of complete skin clearance, defined as a Psoriasis Area and Severity Index score of 0 (PASI = 0), together with minimal impact on quality of life measured by a Dermatology Life Quality Index score of 0 or 1 (DLQI 0/1), occurred in 11.5% of patients receiving bimekizumab compared with 4.6% of those receiving secukinumab as early as week four (P < 0.001).

At week 48, the proportion of patients achieving this combined outcome increased to 61.7% in the bimekizumab group compared with 42.7% in the secukinumab group (P < 0.001).

Durable quality-of-life benefits with bimekizumab over three years

At the start of the open-label extension, 69.2% of patients who had received continuous bimekizumab treatment achieved both PASI 0 and DLQI 0/1, compared with 48.5% of those who switched from secukinumab.

Patients who switched from secukinumab to bimekizumab experienced further improvements, and outcomes in this group gradually approached those observed in the ongoing bimekizumab cohort.

By year three, the proportion of patients achieving complete skin clearance with minimal impact on quality of life was similar between groups, with 62.2% of those receiving continuous bimekizumab and 63.8% of those in the switch group reaching this endpoint.

The authors warned that the eligibility criteria for BE RADIANT inclusion might limit how applicable the findings are to a wider patient population. For instance, patients encountered in routine clinical practice may have specific comorbidities that were part of the trial exclusion criteria. Furthermore, the open-label design and absence of blinding could have introduced bias, they added.

Overall, the results indicate that the clinical effectiveness of bimekizumab is linked to rapid and sustained improvements in symptoms and quality of life for patients with moderate-to-severe plaque psoriasis.

The authors concluded that including PROs alongside traditional clinical measures could offer a more comprehensive assessment of treatment success.

Reference
Augustin M et al. Three-Year Patient-Reported Outcomes From Bimekizumab for Plaque Psoriasis. The BE RADIANT Randomized Clinical Trial With Open-Label Extension. JAMA Dermatol 2026;Feb 18:e256055.