TOPLINE:

Bimekizumab was well tolerated and produced sustained reductions in disease severity, pain, and flares, with most patients with moderate-to-severe hidradenitis suppurativa (HS) attaining an International Hidradenitis Suppurativa Severity Score System (IHS4)-55 response at 48 weeks. Combined medical and surgical treatment enhanced effectiveness, particularly in patients with advanced (Hurley stage III) disease.

METHODOLOGY:

• Researchers conducted a retrospective observational study including 78 adult patients (mean age, 48.5 years; 61.5% men; IHS4 ≥ 4) with moderate-to-severe HS treated with bimekizumab at 10 Spanish hospitals between December 2022 and April 2025.
• Overall, 66.7% of patients received HS dosing of bimekizumab (320 mg every 2 weeks until week 16, followed by the same dose every 4 weeks thereafter) and 19.2% received psoriasis dosing, with 2.6% and 11.5% receiving 320 mg every 4 weeks and every 2 weeks, respectively.
• A total of 39.8% of patients had comorbidities, including 14.1% with concomitant psoriasis and 2.6% with psoriatic arthritis; moreover, 60.3% of patients were identified as those with Hurley stage III and 39.7% were identified as those with Hurley stage II.
• Primary outcomes were changes in mean IHS4 scores, disease severity, and the achievement of IHS4 reduction rates of 55%, 75%, 90%, and 100% at baseline and weeks 16, 24, and 48; secondary outcomes included changes in visual analog scale pain scores, the number of draining tunnels, and monthly flare frequency.

TAKEAWAY:

• The mean IHS4 score dropped from 24.2 at baseline to 14.9 at week 16, 11.4 at week 24, and 7.5 at week 48; disease severity also decreased, with 88.5% of patients with severe disease at baseline dropping to 47.4% at week 16 and 25% at week 48.
• Patients achieving IHS4 reductions increased over time at weeks 16, 24, and 48: IHS4-55 (46.2% vs 67.9% vs 82.1%), IHS4-75 (24.3% vs 30.7% vs 62.5%), IHS4-90 (15.4% vs 2.5% vs 32.1%), and IHS4-100 (9.0% vs 0% vs 23.2%).
• Patient-reported pain, the number of draining tunnels, and monthly flare-ups significantly reduced over time from baseline to week 48 (P < .001 for all).
• Patients with Hurley stage III more frequently used combination therapy, such as systemic antibiotics (31.9% vs 12.9%; P = .047), systemic corticosteroids (12.8% vs 0.0%; P = .042), and surgery (42.6% vs 19.4%; P = .028), than those with Hurley stage II.
• Adverse events occurred in 43.6% of patients, primarily consisting of mild-to-moderate fungal infections (26.9%) and eczematous reactions (8.9%); 10.3% of patients discontinued treatment primarily due to the lack of efficacy.

IN PRACTICE:

"Our real-world data from 48 weeks reinforce the clinical value of bimekizumab as an effective and long-lasting treatment for moderate-to-severe HS," the authors wrote, noting that "combined therapeutic strategies — including systemic antibiotics, corticosteroids, and surgical interventions — were more frequently employed in patients with more extensive structural damage (Hurley stage III), potentially enhancing treatment effectiveness and contributing to the favorable outcomes observed in this subgroup."

SOURCE:

This study was led by Miguel Mansilla-Polo, Hospital Universitario y Politécnico La Fe, Valencia, Spain. It was published online on August 27, 2025, in Dermatology and Therapy.

LIMITATIONS:

This study was retrospective in nature and lacked a control group. Although the sample size was relatively large, it still limited subgroup analyses and the detection of rare adverse events. The absence of validated quality-of-life metrics restricted a more comprehensive assessment of psychosocial burden and patient-centred treatment impact. Additionally, this study was conducted in a single country, which may have limited generalisability to other settings.

DISCLOSURES:

This study did not receive any external funding. One author reported being an editorial board member of Dermatology and Therapy. Several authors reported receiving honoraria and/or travel grants and serving as advisory board members for various biotech and pharmaceutical companies. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.