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Introduction: Psoriatic arthritis (PsA) is a heterogeneous disease with variable treatment responses that remain difficult to predict in routine care [1], [2]. Although bimekizumab has demonstrated robust efficacy and safety in randomized trials [3], [4], [5], real-world data on treatment persistence, reasons for discontinuation, and disease activity outcomes in clinical practice remain scarce. To describe real-world drug survival, reasons for discontinuation, subsequent treatment choices, and short-term disease activity outcomes in patients with PsA treated with bimekizumab in a prospective routine care cohort.

Methods: Data were derived from the prospective PsA Cohort Berlin (PACOB) at the outpatient clinic of the Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, between January 2024 and January 2026. The cohort comprised 200 patients with PsA. Patients treated with bimekizumab during the observation period were identified. Drug survival was estimated using the Kaplan–Meier method. Disease activity measures (DAPSA, TJC28, SJC28, VAS pain, PASI, LEI) were compared at baseline and at approximately three months using the Wilcoxon signed-rank test.

Results: Of 200 patients with PsA, 28 received bimekizumab and were included in the analysis. The median age at treatment initiation was 51.1 years (IQR 43.1–65.3); 17 (61%) were female. Bimekizumab was used as first-line biologic in 5 patients (18%), with the remainder having received a median of 2 prior b/tsDMARDs (IQR 1-4). Twelve-month drug survival was 53.2% (95% CI 28.9–72.6%). Twelve patients (42.9%) discontinued bimekizumab, most commonly due to inadequate response (n = 7, 58.3%) and adverse events (n = 5, 41.7%), predominantly fungal infections. Among patients who discontinued, 10 of 12 (83.3%) switched to another bDMARD; notably, 3 of 5 patients who stopped due to an adverse event subsequently received another IL-17 inhibitor. Patients with fewer prior b/tsDMARDs (0–2) showed numerically longer drug survival than those with 3 prior treatments (log-rank p = 0.296). Among 16 patients with available paired date, consistent trends toward improvement were observed across all disease activity measures at approximately three months, with DAPSA declining from a median of 15.2 to 9.7 (p = 0.25) and 70% achieving low disease activity or remission at follow-up compared with 40% at baseline.

Conclusion: In this real-world PsA cohort, bimekizumab demonstrated acceptable drug survival with the majority of patients remaining on treatment at one year. Inadequate response and adverse events were the primary reasons for discontinuation. Short-term disease activity trends were encouraging, though significance was not reached given the sample size. These findings provide a basis for larger comparative analyses of bimekizumab persistence and response in routine clinical practice.

Disclosures: DS/AK/TW received speaker honoraria and performed consultancy work for UCB, Abbvie, Novartis, Janssen, Alphasigma and Lilly. MN, AB: nothing to declare.

Literatur

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