Philip Mease, MD, MACR

Continuing the Managed Healthcare Executive Between the Lines series, Philip Mease, MD, of Swedish Medical Center, Providence St. Joseph Health, and the University of Washington, asks Saakshi Khattri, MD, of the Icahn School of Medicine at Mount Sinai, to reflect on her real-world experience with bimekizumab's safety profile and the broader clinical takeaways from the BE BOLD trial.

In this installment of the Managed Healthcare Executive Between the Lines series, Philip Mease, MD, of Swedish Medical Center, Providence St. Joseph Health, and the University of Washington, walks through the actual 16-week efficacy and safety results from the BE BOLD head-to-head trial of bimekizumab versus risankizumab in active psoriatic arthritis.

Continuing the Managed Healthcare Executive Between the Lines series, moderator Philip Mease, MD, of Swedish Medical Center, Providence St. Joseph Health, and the University of Washington, and guest Saakshi Khattri, MD, of the Icahn School of Medicine at Mount Sinai, shift from the broader disease burden discussion to how biologics are actually being used in practice today, before laying out the design of the BE BOLD trial.

Welcome back to another Managed Healthcare Executive Between the Lines series. In this opening episode, moderator Philip Mease, MD, Director of Rheumatology Research at Swedish Medical Center, Providence St. Joseph Health, and Clinical Professor at the University of Washington, is joined by Saakshi Khattri, MD, Director of the Center for Connective Tissue Diseases at the Icahn School of Medicine at Mount Sinai, to lay the groundwork for a discussion on the BE BOLD head-to-head trial of bimekizumab versus risankizumab in active psoriatic arthritis (PSA).

Panelists discuss how bimekizumab represents a valuable addition to the psoriatic arthritis treatment armamentarium, given its novel dual mechanism, ability to address multiple disease domains and potential to benefit patients who have lost response to other biologics, reducing healthcare burden and improving societal economic outcomes.

Panelists discuss how bimekizumab treatment preserves workforce participation and productivity while maintaining a favorable safety profile. Oral candidiasis is the main distinguishing side effect compared with other IL-17 inhibitors, although it is rarely encountered in clinical practice.

Panelists discuss how bimekizumab showed significant improvements across multiple health-related quality of life measures, including the Psoriatic Arthritis Impact of Disease (PsAID)-12, Psoriatic Arthritis Quality of Life measure, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), demonstrating comprehensive benefits beyond just physical symptoms.

Panelists discuss how bimekizumab demonstrated significant improvements in pain scores (from baseline levels around 60/100) and fatigue measures, with meaningful percentages of patients achieving clinically important reductions that translate to noticeable real-world benefits.

Panelists discuss how the clinical trial populations, characterized by middle-aged males with elevated body mass index (BMI) and moderate disease burden, accurately reflect real-world patients with psoriatic arthritis seen in clinical practice, including those with oligoarticular disease.

Panelists discuss how the BE OPTIMAL study enrolled biologic-naive patients, whereas BE COMPLETE enrolled TNF inhibitor-inadequate responders. Both populations showed similar response rates despite the typical expectation of blunted effects in biologic-experienced patients.

Panelists discuss how bimekizumab’s dual IL-17A and IL-17F inhibition mechanism distinguishes it from other biologics and may provide effective treatment options for patients who have lost response to TNF inhibitors or IL-17A-only inhibitors.

Panelists discuss how patients with psoriatic arthritis primarily present with pain in joints and enthesial sites, along with debilitating morning stiffness and fatigue that severely impacts their ability to perform daily activities and work functions.

Panelists discuss how patient-reported outcomes (PROs) are critical in psoriatic arthritis clinical trials because the disease affects multiple domains, including skin, joints, entheses and spine, creating a complex symptom burden that significantly impacts patients’ pain, fatigue and quality of life.