Treatment Selection for Psoriatic Arthritis

EP: 1.Background on PROs in Psoriatic Arthritis

EP: 2.Common Symptoms and Treatments in Psoriatic Arthritis

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EP: 3.Treatment Selection for Psoriatic Arthritis

EP: 4.Key Differences in Inclusion Criteria Between BE OPTIMAL and BE COMPLETE

Bimekizumab represents a therapeutic advancement through its novel dual mechanism targeting interleukin-17A and IL-17F, distinguishing it from existing IL-17A inhibitors like secukinumab and ixekizumab. This comprehensive IL-17 pathway inhibition provides a more complete blockade of inflammatory stimuli, as recent research demonstrates that targeting both A and F components enhances overall therapeutic effectiveness. The dual inhibition approach also differs significantly from TNF inhibitors, although cross-pathway interactions exist where TNF inhibition provides some IL-17 suppression and vice versa.

Clinical evidence supports bimekizumab’s effectiveness in patients who have failed previous treatments, including both TNF-alpha and IL-17A inhibitors. Dr. Mease reports observing good responses in practice when switching patients to bimekizumab after losing efficacy on other biologics, supported by Canadian case series data demonstrating effectiveness following IL-17A inhibitor failure. This suggests that the additional IL-17F inhibition or the fresh therapeutic approach may provide renewed efficacy in treatment-experienced patients.

Patient treatment selection priorities focus significantly on safety profiles, with IL-17 inhibitors offering advantages through minimal signals for serious infections, malignancy, or cardiovascular complications compared with other biologic classes. Beyond safety, patients value comprehensive disease domain coverage, and bimekizumab demonstrates effectiveness across multiple manifestations, including peripheral joints, skin, axial involvement, enthesitis and dactylitis. This broad efficacy spectrum, supported by data from ankylosing spondylitis and nonradiographic axial spondyloarthritis trials, allows clinicians to confidently address the various “sections of the orchestra” that may be active in individual patients at any given time.