Characteristics and Clinical Outcomes of Patients With Hidradenitis Suppurativa (HS) Treated With Bimekizumab: A Canadian Retrospective Chart Review

ABSTRACT Background Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory skin disease characterised by painful nodules, abscesses, and draining and non‐draining tunnels. Currently, there are two biologics approved in Canada for the treatment of moderate‐to‐severe HS, adalimumab (anti‐TNF) and secukinumab (anti‐IL‐17A). However, there remains a high unmet need to manage moderate‐to‐severe HS. Bimekizumab (BKZ), a humanised IgG monoclonal antibody that inhibits IL‐17A and IL‐17F, offers broader IL‐17 pathway inhibition and may provide enhanced clinical benefit relative to IL‐17A‐selective inhibitors. Objectives We aimed to evaluate disease characteristics and real‐world clinical outcomes in Canadian patients with moderate‐to‐severe HS treated with BKZ. Methods This retrospective chart review included 27 patients with moderate‐to‐severe HS prior to initiation of BKZ. All patients were initiated on BKZ 320 mg every 4 weeks (Q4W) for 16 weeks followed by every 8 weeks (Q8W) (except for two patients on every 2 weeks [Q2W]) thereafter. Results Twenty‐two patients (81%) had severe disease with majority having an abscess and nodule (AN) count > 5, draining tunnels, pain scores ≥ 6, mean DLQI of 23, and significant comorbidities; 18 patients (67%) had Hurley stage III disease. Patients in this cohort had received multiple prior treatments including oral antibiotics ( n = 26, 96%), adjunct systemics ( n = 25, 93%) and intravenous ertapenem ( n = 3, 11%). Prior to receiving BKZ, 25 patients (93%) were treated with adalimumab and 8 (30%) with secukinumab. BKZ was generally well‐tolerated, with no treatment‐related adverse events reported in 16 patients (59%). Candidiasis was the most common adverse event ( n = 6, 22%) and did not lead to discontinuation. Median AN count, draining tunnels, pain scores, and disease severity decreased at first follow‐up and continued to improve thereafter. No new safety signals emerged. Conclusions These findings support BKZ as a promising therapeutic option for moderate‐to‐severe HS and highlight the continued need for effective treatments in this population.