Comparative Effectiveness of Bimekizumab in Patients with Psoriatic Arthritis: Results from a Systematic Literature Review and Network Meta-Analysis

Objectives: To compare the relative efficacy and safety of bimekizumab, a selective inhibitor of interleukin (IL)-17F in addition to IL-17A, against approved biologic- and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) for psoriatic arthritis (PsA). Methods: A systematic literature review (SLR) was conducted following PRISMA guidelines to identify randomized controlled trials of b/tsDMARDs in PsA published January 1991 through 2 May 2022. Bayesian binomial fixed-effect and random-effects network meta-analyses (NMAs) were conducted for efficacy outcomes (American College of Rheumatology [ACR] 20/50/70, Psoriasis Area and Severity Index [PASI] 90/100) for b/tsDMARD-naïve (bio-naïve) and tumor necrosis factor inhibitor-experienced (TNFi-experienced) patients using data at week 16, or 12/24 if unavailable. Serious adverse events (SAEs) were analyzed in a mixed bio-naïve/TNFi-experienced population using week 12–24 data. Analyses in bio-naïve patients were adjusted for variation in baseline risk across RCTs. Treatments were ranked according to surface under the cumulative ranking curve (SUCRA) values. Results: 41 RCTs were identified that met NMA inclusion criteria. In the NMA in bio-naïve patients, bimekizumab ranked 6th for ACR20 (SUCRA=0.75), 5th for ACR50 (SUCRA=0.74), and 3rd for ACR70 (SUCRA=0.81) among 21 treatments. In TNFi-experienced patients, bimekizumab ranked 1st among 16 treatments for ACR20 (SUCRA=0.98), 2nd among 15 treatments for ACR50 (SUCRA=0.84) and 1st among 15 treatments for ACR70 (SUCRA=0.83). For PASI90 and PASI100 in bio-naïve patients, bimekizumab ranked 2nd among 15 treatments (SUCRA=0.89) and 1st among 11 treatments (SUCRA=0.95), respectively. For PASI90 and PASI100 in TNFi-experienced patients, bimekizumab ranked 1st among 10 treatments (SUCRA=0.81) and 2nd among 7 treatments (SUCRA=0.79), respectively. In the mixed population, bimekizumab was comparable to other b/tsDMARDs for SAEs. Conclusions: According to this NMA, bimekizumab was one of the highest-ranked ...