Does the response to bimekizumab vary according to previous therapy with methotrexate<i> versus </i>cyclosporine?

According to the Italian Medicines Agency (AIFA) guidelines, patients with moderate-to-severe psoriasis can access biological therapies in case of treatment failure or contraindication to at least one conventional systemic treatment. However, no studies have been conducted to investigate the potential influence of previous conventional systemic treatments on the efficacy of subsequently prescribed biologics. The purpose of this study was to evaluate whether patients treated with bimekizumab, a monoclonal anti-interleukin (IL)-17A/F drug, achieve Psoriasis Area and Severity Index (PASI) 90 at different times based on prior use of cyclosporine or methotrexate. Fifty-four patients were enrolled in this study; 29 had previously been treated with methotrexate and 25 with cyclosporine. There was a statistically significant difference in efficacy (measured by mean PASI score) at week 4 (p<0.01), with patients treated with methotrexate responding faster to bimekizumab. Females previously on treatment with cyclosporine responded better and faster, followed by females on methotrexate and then men on methotrexate. Men on cyclosporine showed a later response to bimekizumab. Our study confirmed that bimekizumab is a fast and effective biologic treatment for psoriasis. Patients previously treated with methotrexate responded faster to bimekizumab than those formerly treated with cyclosporine.