INTRODUCTION
Some psoriatic disease topical treatments, such as coal tar and salicylic acid, have stood the test of time, being used consistently over the past century.1 However, the landscape of systemic medications used to treat psoriasis has undergone significant evolution in a fraction of the time. Since their first approval by the US Food and Drug Administration (FDA) in 2003, biologics have transformed the treatment of moderate-to-severe psoriasis because of their high degree of efficacy.1 These include T-cell targeted agents, tumor necrosis factor (TNF)-α inhibitors, interleukin (IL)-17 inhibitors, IL-12/23 inhibitors, and IL-23 inhibitors. The newest approved biologic in the United States is bimekizumab, a selective inhibitor of both IL-17A and IL-17F, which has shown significant, long-term clinical efficacy in randomized clinical trials.2,3,4 In fact, it has even been shown to be superior to other psoriasis biologic treatments, including IL-17A, IL-12/23, and TNF-α inhibition.5-7
The choice of psoriatic disease therapy is patient-dependent and involves the consideration of many factors, including patient preference. When queried on what aspects of treatment they valued, many psoriasis patients value effectiveness, rapidity of response, and longevity of response the most.8 As such, dermatologists should focus on providing patients with treatment options that are rapid acting, effective while safe, and long-lasting. Two studies investigating the rapidity of the response of biologic treatments for moderate-to-severe psoriasis found that IL-17 inhibitors brodalumab and ixekizumab yielded the overall fastest response rate.9,10 Utilizing Bayesian and Frequentist network meta-analyses of phase 3, double-blind, randomized, controlled trials testing IL-17, IL-12/-23, IL-23, and TNF inhibitors for the treatment of moderate-to-severe psoriasis, Warren et al found more rapid therapeutic effects on Psoriasis Area and Severity Index (PASI) 75 and 90 response rates at weeks 2, 4, and 8 with ixekizumab and brodalumab.9 Egeberg et al similarly found that brodalumab and ixekizumab yielded the shortest time to achieve PASI 90 in 25% and 50% of patients in their systematic review of phase 3 clinical trials of IL-17 and IL-23 inhibitors for moderate-to-severe psoriasis in adult patients.10 However, it is important to note that these studies were performed prior to the approval of bimekizumab. Since then, bimekizumab has shown in head-to-head clinical trials to be more rapid-acting than other psoriasis treatments.5-7 Herein, we describe a case of treatment naïve moderate-to-severe plaque psoriasis with significant clearance within 72 hours of treatment with bimekizumab.
The choice of psoriatic disease therapy is patient-dependent and involves the consideration of many factors, including patient preference. When queried on what aspects of treatment they valued, many psoriasis patients value effectiveness, rapidity of response, and longevity of response the most.8 As such, dermatologists should focus on providing patients with treatment options that are rapid acting, effective while safe, and long-lasting. Two studies investigating the rapidity of the response of biologic treatments for moderate-to-severe psoriasis found that IL-17 inhibitors brodalumab and ixekizumab yielded the overall fastest response rate.9,10 Utilizing Bayesian and Frequentist network meta-analyses of phase 3, double-blind, randomized, controlled trials testing IL-17, IL-12/-23, IL-23, and TNF inhibitors for the treatment of moderate-to-severe psoriasis, Warren et al found more rapid therapeutic effects on Psoriasis Area and Severity Index (PASI) 75 and 90 response rates at weeks 2, 4, and 8 with ixekizumab and brodalumab.9 Egeberg et al similarly found that brodalumab and ixekizumab yielded the shortest time to achieve PASI 90 in 25% and 50% of patients in their systematic review of phase 3 clinical trials of IL-17 and IL-23 inhibitors for moderate-to-severe psoriasis in adult patients.10 However, it is important to note that these studies were performed prior to the approval of bimekizumab. Since then, bimekizumab has shown in head-to-head clinical trials to be more rapid-acting than other psoriasis treatments.5-7 Herein, we describe a case of treatment naïve moderate-to-severe plaque psoriasis with significant clearance within 72 hours of treatment with bimekizumab.
