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Le traitement par bimekizumab a été efficace à 2 ans, quelle que soit la durée des symptômes de l’axSpA : résultats de deux essais de phase III - 26/11/24

Doi : 10.1016/j.rhum.2024.10.067 
S. Ramiro 1, F. Proft 2, R. Sengupta 3, A. Van Tubergen 4, A. Molto 5, , L.S. Gensler 6, M. Kishimoto 7, V. Taieb 8, D. Voiniciuc 9, U. Massow 10, V. Navarro-Compán 11
1 Leiden University Medical Center, Department of Rheumatology, Leiden, Pays-Bas 
2 Department of Gastroenterology, Infectiology and Rheumatology (including Nutrition Medicine), Charité – Universitätsmedizin Berlin, Freie Universität & Humboldt-Universität zu Berlin, Berlin, Allemagne 
3 The Royal National Hospital for Rheumatic Diseases, Sulis Hospital and Bath Clinic, Bath, Royaume Uni 
4 Maastricht University Medical Center, Department of Medicine, Division of Rheumatology, Maastricht, Pays-Bas 
5 Groupe Hospitalier Cochin, AP–HP, Paris 
6 Department of Medicine/Rheumatology, University of California, San Francisco, CA, États-Unis 
7 Kyorin University School of Medicine, Department of Nephrology and Rheumatology, Tokyo, Japon 
8 Rheumatology, UCB, Colombes 
9 Rheumatology, UCB, Slough, Royaume Uni 
10 Rheumatology, UCB, Monheim am Rhein, Allemagne 
11 La Paz University Hospital, IdiPaz, Department of Rheumatology, Madrid, Espagne 

Auteur correspondant.

Resumen

Introduction

Bimekizumab (BKZ), an IgG1 monoclonal antibody that selectively inhibits IL-17F in addition to IL-17A, has shown efficacy through week (W) 52 in patients (pts) with non-radiographic/radiographic axial spondyloarthritis (nr-/r-axSpA) in two phase III trials [1]. We compare the impact of symptom duration on the efficacy of BKZ at 2 years.

Patients et méthodes

In BE MOBILE 1 (nr-axSpA; NCT03928704) and 2 (r-axSpA; NCT03928743), pts were randomized to BKZ or placebo (PBO); all received BKZ from W16 to W52. At W52, pts could enter the open-label extension study (NCT04436640) and receive BKZ. We present results through W104 for pts with a duration of symptoms (DoS) ≤2/>2 years (ASAS definition of early axSpA) [2], and ≤5/>5 years to optimize subgroup sizes. Pts who received continuous BKZ and those who switched from PBO to BKZ were pooled from W52.

We present ASAS40 (non-responder imputation), ASDAS<2.1, and change from baseline in BASDAI (CfB; multiple imputation) for pts with DoS ≤5/>5 (BE MOBILE 1 and 2) and ≤2/>2 (BE MOBILE 1), mean SPARCC score on sacroiliac joint MRI (observed cases) for pts with DoS ≤5/>5 in BE MOBILE 1. To compare the efficacy of BKZ vs PBO according to DoS, we calculated relative odds ratios (ASAS40/ASDAS<2.1) and relative differences (BASDAI CfB/SPARCC) at W16, if sample size allowed.

Résultats

Better outcomes were observed with BKZ vs. PBO at W16, regardless of DoS. Results were maintained/improved through W104. At W16, more BKZ-treated pts with DoS ≤5/≤2 achieved ASAS40/ASDAS<2.1 compared with patients with DoS>5/>2, respectively. No significant differences were detected between DoS5/>5 (BE MOBILE 1 and 2) or between DoS2/>2 (BE MOBILE 1). At W104, more pts with DoS5/≤2 achieved ASAS40/ASDAS<2.1 (Figure 1, Figure 2).

No significant relative difference in mean BASDAI CfB between DoS5/>5 or ≤2/>2 was detected at W16 in BE MOBILE 1, but a greater improvement was seen in BASDAI in pts with DoS5 vs.>5 in BE MOBILE 2. Improvements in mean BASDAI were greater at W104 in pts with DoS5/≤2 vs>5/>2, respectively (Figure 3).

Baseline SPARCC scores indicated greater inflammation in pts with DoS5 vs>5. BKZ treatment resulted in a reduction in mean SPARCC scores at W16; compared with PBO, no significant difference was detected between DoS≤5/>5 in BE MOBILE 1 (relative difference [95% CI]: –3.10 [–8.09, 1.90]). Mean SPARCC scores remained low through W104 (DoS5: 2.03 [n=40], DoS>5: 2.83 [n=55]) and indicated resolution of inflammation, regardless of DoS.

Conclusion

BKZ treatment was effective at 2 years, regardless of symptom duration, with no difference observed in treatment effect at W16 between pts with shorter symptom duration and those with longer symptom duration.

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© 2024  Publicado por Elsevier Masson SAS.
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Vol 91 - N° S1

P. A206-A208 - décembre 2024 Regresar al número
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