2255: Bimekizumab versus Secukinumab for the Treatment of Nail Psoriasis in Patients with Moderate to Severe Plaque Psoriasis: Results from the BE RADIANT Phase 3b Trial

Kilian Eyerich¹, Alice B. Gottlieb², Stefano Piaserico³, Stefan Beissert⁴, Melinda Gooderham⁵, Brian Kirby⁶, Nicola Tilt⁷, Cynthia Madden⁸, Susanne Wiegratz⁹, Dirk de Cuyper¹⁰, Joseph F. Merola¹¹ and Boni Elewski¹², ¹Department of Dermatology, Medical Center, University of Freiburg, Freiburg, Germany, ²Icahn School of Medicine at Mount Sinai, New York, NY, ³Dermatology Unit, Department of Medicine, Università di Padova, Padova, Italy, ⁴Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany, ⁵SKiN Centre for Dermatology, Probity Medical Research, Peterborough, ON, Canada, and Queen’s University, Kingston, ON, Canada, ⁶Elm Park and the Charles Institute, St Vincent's University Hospital, University College Dublin, Dublin, Ireland, ⁷UCB Pharma, Slough, United Kingdom, ⁸UCB Pharma, Morrisville, NC, ⁹UCB Pharma, Monheim am Rhein, Germany, ¹⁰UCB Pharma, Brussels, Belgium, ¹¹Brigham and Women's Hospital and Harvard Medical School, Boston, MA, ¹²Department of Dermatology, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH

Background/Purpose: Psoriatic lesions in highly visible areas, including the nails, disproportionately affect patients' health‑related quality of life.[1] Here, we compare the efficacy of bimekizumab (BKZ) vs secukinumab (SEC) through 48 weeks (wks) for the treatment of nail psoriasis in patients with moderate to severe plaque psoriasis who had moderate to severe nail involvement at baseline.

Methods: In BE RADIANT, patients were randomized to BKZ 320mg every 4 wks (Q4W) or SEC 300mg weekly to Wk4 then Q4W. From Wk16, BKZ-randomized patients received BKZ Q4W or Q8W.[2] In this analysis, BKZ Q4W/Q4W and Q4W/Q8W were combined (BKZ Total). Modified Nail Psoriasis Severity Index (mNAPSI; total fingernail on a 0–130 scale) and mNAPSI sub-scores from Wks16–48 among patients with baseline mNAPSI >10 were assessed. Missing data were imputed as non-response (NRI).

Results: In total, 116 BKZ-treated and 99 SEC-treated patients had baseline mNAPSI >10; 37.1% and 40.4% achieved mNAPSI≤2 at Wk16; 75.0% and 59.6% achieved mNAPSI≤2 at Wk48. From Wks16–48, mNAPSI=0 (clear) response rates increased from 26.7% to 70.7% (BKZ), and 33.3% to 53.5% (SEC). 101 BKZ-treated and 86 SEC-treated patients had both baseline mNAPSI >10 and baseline nail pitting >0; 36.6% and 41.9% achieved nail pitting=0 (clear) at Wk16; 78.2% and 59.3% achieved nail pitting=0 at Wk48. 69 BKZ-treated and 56 SEC-treated patients had both baseline mNAPSI >10 and baseline nail plate crumbling >0; 65.2% and 69.6% achieved nail plate crumbling=0 (clear) at Wk16; 85.5% and 75.0% achieved nail plate crumbling=0 at Wk48. 59 BKZ-treated and 58 SEC‑treated patients had both baseline mNAPSI >10 and baseline leukonychia >0; 69.5% and 70.7% achieved leukonychia=0 (clear) at Wk16; 79.7% and 69.0% achieved leukonychia=0 at Wk48.

Conclusion: From Wks16–48, BKZ-treated patients showed numerically greater improvements in nail psoriasis than SEC‑treated patients, including complete nail clearance.

Funding: This study was funded by UCB Pharma. Medical writing provided by Costello Medical and funded by UCB Pharma.

References: 1. Augustin M et al. Br J Dermatol 2019;181(2):358–65; 2. Reich K et al. N Engl J Med 2021;385(2):142–52, NCT03536884. Abstract previously submitted to AAD 2023.


K. Eyerich: AbbVie, 12, Speaker and/or advisor for:, Almirall, 12, Speaker and/or advisor for:, Boehringer Ingelheim, 12, Speaker and/or advisor for:, Bristol Myers Squibb, 12, Speaker and/or advisor for:, Eli Lilly, 12, Speaker and/or advisor for:, Janssen, 12, Speaker and/or advisor for:, LEO Pharma, 12, Speaker and/or advisor for:, Novartis, 12, Speaker and/or advisor for:, Pfizer, 12, Speaker and/or advisor for:, Sanofi, 12, Speaker and/or advisor for:, UCB Pharma, 12, Speaker and/or advisor for:; A. Gottlieb: Amgen, 1, 2, AnaptysBio, 1, 2, 5, Avotres Therapeutics, 1, 2, Boehringer Ingelheim, 1, 2, Bristol Myers Squibb, 1, 2, 5, Dice Therapeutics, 1, 2, Eli Lilly, 1, 2, Janssen, 1, 2, MoonLake Immunotherapeutics, 5, Novartis, 1, 2, 5, Sanofi, 1, 2, UCB Pharma, 1, 2, 5, XBiotech, 1, 2; S. Piaserico: AbbVie, 2, 6, Almirall, 2, 6, Celgene, 2, 6, Eli Lilly, 2, 6, Janssen, 2, 6, LEO Pharma, 2, 6, Merck, 2, 6, Novartis, 2, 6, Pfizer, 2, 6, Sandoz, 2, 5, UCB Pharma, 2, 6; S. Beissert: AbbVie, 6, Actelion, 6, Amgen, 6, Bristol Myers Squibb, 6, Celgene, 6, Eli Lilly, 6, Galderma, 6, GSK, 6, Janssen, 6, LEO Pharma, 6, Menlo Therapeutics, 6, MSD, 6, Novartis, 6, Pfizer, 6, Roche Posay, 6, UCB Pharma, 6; M. Gooderham: AbbVie, 12, Investigator, speaker, consultant or advisory board member for:, Akros, 12, Investigator, speaker, consultant or advisory board member for:, Amgen, 12, Investigator, speaker, consultant or advisory board member for:, AnaptysBio, 12, Investigator, speaker, consultant or advisory board member for:, Arcutis, 12, Investigator, speaker, consultant or advisory board member for:, Aslan, 12, Investigator, speaker, consultant or advisory board member for:, Bausch Health, 12, Investigator, speaker, consultant or advisory board member for:, Boehringer Ingelheim, 12, Investigator, speaker, consultant or advisory board member for:, Bristol Myers Squibb, 12, Investigator, speaker, consultant or advisory board member for:, Celgene, 12, Investigator, speaker, consultant or advisory board member for:, Dermavant, 12, Investigator, speaker, consultant or advisory board member for:, Dermira, 12, Investigator, speaker, consultant or advisory board member for:, Eli Lilly, 12, Investigator, speaker, consultant or advisory board member for:, Galderma, 12, Investigator, speaker, consultant or advisory board member for:, GSK, 12, Investigator, speaker, consultant or advisory board member for:, Incyte, 12, Investigator, speaker, consultant or advisory board member for:, Janssen, 12, Investigator, speaker, consultant or advisory board member for:, Kyowa Kirin, 12, Investigator, speaker, consultant or advisory board member for:, MedImmune, 12, Investigator, speaker, consultant or advisory board member for:, Meiji, 12, Investigator, speaker, consultant or advisory board member for:, Merck, 12, Investigator, speaker, consultant or advisory board member for:, Moonlake Immunotherapeutics, 12, Investigator, speaker, consultant or advisory board member for:, Nimbus, 12, Investigator, speaker, consultant or advisory board member for:, Novartis, 12, Investigator, speaker, consultant or advisory board member for:, Pfizer, 12, Investigator, speaker, consultant or advisory board member for:, Regeneron, 12, Investigator, speaker, consultant or advisory board member for:, Reistone, 12, Investigator, speaker, consultant or advisory board member for:, Sanofi-Genzyme, 12, Investigator, speaker, consultant or advisory board member for:, Sun Pharma, 12, Investigator, speaker, consultant or advisory board member for:, UCB Pharma, 12, Investigator, speaker, consultant or advisory board member for:; B. Kirby: AbbVie, 1, 2, 6, 12, Received research support from or has been a principal investigator (clinical trials) for:, Almirall, 1, 2, 6, 12, Received research support from or has been a principal investigator (clinical trials) for:, Celgene, 1, 2, 6, Eli Lilly, 1, 6, Janssen, 1, 2, 6, 12, Received research support from or has been a principal investigator (clinical trials) for:, Merck, 2, 12, Received research support from or has been a principal investigator (clinical trials) for:, Moonlake Immunotherapeutics, 1, 2, 6, 12, Received research support from or has been a principal investigator (clinical trials) for:, Novartis, 1, 2, 6, 12, Received research support from or has been a principal investigator (clinical trials) for:, Pfizer, 1, 2, 6, 12, Received research support from or has been a principal investigator (clinical trials) for:, UCB Pharma, 1, 2, 6, 12, Received research support from or has been a principal investigator (clinical trials) for:; N. Tilt: UCB Pharma, 3, 11; C. Madden: UCB Pharma, 3, 11; S. Wiegratz: UCB Pharma, 3, 11; D. de Cuyper: UCB Pharma, 3, 11; J. Merola: AbbVie, 12, Consultant and/or investigator, Amgen, 2, Biogen, 12, Consultant and/or investigator, Bristol Myers Squibb, 2, Dermavant, 12, Consultant and/or investigator, Eli Lilly, 12, Consultant and/or investigator, Janssen, 12, Consultant and/or investigator, LEO Pharma, 12, Consultant and/or investigator, Novartis, 12, Consultant and/or investigator, Pfizer, 12, Consultant and/or investigator, Regeneron, 12, Consultant and/or investigator, Sanofi, 12, Consultant and/or investigator, Sun Pharmaceuticals, 12, Consultant and/or investigator, UCB Pharma, 12, Consultant and/or investigator; B. Elewski: AbbVie/Abbott, 12, Received research support as funding to Case Western Reserve University from:, AnaptysBio, 12, Received research support as funding to Case Western Reserve University from:, Arcutis, 2, Boehringer Ingelheim, 2, 12, Received research support as funding to Case Western Reserve University from:, Bristol Myers Squibb, 2, 12, Received research support as funding to Case Western Reserve University from:, Celgene, 2, 12, Received research support as funding to Case Western Reserve University from:, Eli Lilly, 2, 12, Received research support as funding to Case Western Reserve University from:, Incyte, 12, Received research support as funding to Case Western Reserve University from:, LEO Pharma, 2, 12, Received research support as funding to Case Western Reserve University from:, Menlo, 2, 12, Received research support as funding to Case Western Reserve University from:, Novartis, 2, 12, Received research support as funding to Case Western Reserve University from:, Pfizer, 2, 12, Received research support as funding to Case Western Reserve University from:, Regeneron, 12, Received research support as funding to Case Western Reserve University from:, Sun Pharma, 2, 12, Received research support as funding to Case Western Reserve University from:, UCB Pharma, 2, Valeant, 2, 12, Received research support as funding to Case Western Reserve University from:, Vanda, 12, Received research support as funding to Case Western Reserve University from:, Verrica, 2.