TOPLINE:

In a retrospective cohort study, adults with psoriasis treated with bimekizumab, a dual interleukin (IL)-17A/F inhibitor, did not experience a higher risk for depression or suicidal ideation compared with those receiving IL-23 inhibitors.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using the TriNetX US Collaborative Network, of adults with psoriasis who initiated bimekizumab (Bimzelx) or IL-23 inhibitors (risankizumab, guselkumab, tildrakizumab, or ustekinumab).
• After 1:1 propensity score matching, the study included 1896 individuals who received IL-23 inhibitors and 1896 who were treated with bimekizumab (median age, 50.8 years; 3% women; 79% White individuals and 6.5% Black individuals).
• The primary outcome was new-onset depression, major depressive disorder (MDD), or suicidal ideation and use of antidepressants and antipsychotics from 30 days to 730 days (2 years) after treatment initiation.
• Patients with prior depression, MDD, suicidal ideation, or use of antidepressants and antipsychotics were excluded, leaving 855 IL-23-treated and 836 bimekizumab-treated patients for the analysis.

TAKEAWAY:

• During follow-up, 12% of those on IL-23 inhibitors and 4.9% of those on bimekizumab developed depression, suicidal ideation, or was on antidepressant or antipsychotic treatment (risk ratio, 2.43; 95% CI, 1.715-3.451).
• In a sensitivity analysis limited to 1-6 months after treatment initiation, no significant difference in the incidence of depression or suicidal ideation was reported between the two groups.
• Over 6 months, the cumulative incidence of depression or suicidal ideation was 4.0% among those on IL-23 inhibitors and 2.7% among those on bimekizumab (P = .125).

IN PRACTICE:

“Our findings suggest that bimekizumab is not associated with an increased risk of depression or suicidal ideation relative to IL-23 inhibitors in patients with psoriasis in real-world clinical settings,” the authors wrote. “Routine mental-health screening remains essential in patients receiving biologic therapy; however, these findings provide reassurance that bimekizumab does not confer additional psychiatric risk relative to other advanced biologics,” they added.

SOURCE:

This study was led by Christina Tolete, BS, Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC, and was published online on February 23 in JAAD International.

LIMITATIONS:

The study limitations included observational design, short follow-up, and reliance on diagnostic codes and medication records.

DISCLOSURES:

The authors reported no funding source. Two authors reported receiving consulting, speaker, and advisory fees from several drug companies including, Arcutis, Bristol Myers Squibb, Eli Lilly, Incyte, Leo Pharma, La Roche Posay, Galderma, Kenvue, Microcures, Leo Pharma, and Pfizer.

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