J Eur Acad Dermatol Venereol. 2025 Dec 28. doi: 10.1111/jdv.70265. Online ahead of print.
ABSTRACT
BACKGROUND: Given the lack of head-to-head studies of approved biologic therapies in hidradenitis suppurativa (HS), a chronic, recurrent inflammatory skin disease, a systematic literature review (SLR) and network meta-analysis (NMA) were conducted to provide insight into their comparative short-term efficacy.
OBJECTIVE: To assess the relative efficacy of approved biologic therapies (bimekizumab 320 mg every 2 weeks [Q2W], secukinumab 300 mg Q2W and every 4 weeks [Q4W] and adalimumab 40 mg every week [QW]) at Week 12-16 in moderate-to-severe HS.
METHODS: A clinical SLR identified randomised controlled trials until 3rd July 2024 for inclusion in Bayesian NMAs. Two evidence networks (predominantly biologic-naïve and biologic-experienced) were constructed to represent populations with differing biologic treatment histories. Outcomes of interest were improved HS Clinical Response (HiSCR; ≥50%/≥75%/≥90%/100%), change from baseline (CFB) in International Hidradenitis Suppurativa Severity Score System (IHS4) and improvement from baseline of ≥55% (IHS4-55). Percentage CFB in abscess and inflammatory nodule (AN) count and CFB in absolute draining tunnels (DT) count were also assessed.
RESULTS: The NMA included nine trials. Bimekizumab ranked as the most efficacious treatment across all predefined efficacy outcomes in both predominantly biologic-naïve and biologic-experienced networks, showing consistent response levels. In the predominantly biologic-naïve network, bimekizumab Q2W compared with secukinumab (Q4W) demonstrated significantly higher odds of response for all HiSCR outcomes (odds ratio [OR]: HiSCR50 = 1.69; HiSCR75 = 1.85; HiSCR90 = 1.62; HiSCR100 = 1.88) and IHS4-55 (OR = 1.91), and for HiSCR75 (OR = 1.60) and HiSCR90 (OR = 1.56) compared with adalimumab QW. Similar results were observed for secukinumab Q2W and both secukinumab dosing regimens in the biologic-experienced network. Note, adalimumab studies did not report the proportion of biologic-experienced patients. Systematic review of safety data is required for full benefit-risk assessment and decision-making.
CONCLUSION: This NMA, the first to adjust for intercurrent events in moderate-to-severe HS across multiple efficacy outcomes, assessed up-to-date data, with estimates demonstrating bimekizumab's favourable efficacy among approved biologics.
PMID:41457056 | DOI:10.1111/jdv.70265