Long‐term efficacy of biologics in moderate‐to‐severe hidradenitis suppurativa: A systematic review and MAIC

BACKGROUND: There is a lack of direct comparative studies evaluating the long-term efficacy of the approved biologic therapies bimekizumab, secukinumab and adalimumab for moderate-to-severe hidradenitis suppurativa (HS) beyond Week 16. To address this evidence gap, this study uses matching-adjusted indirect comparisons (MAIC) to assess and compare their sustained efficacy. OBJECTIVE: To assess the long-term relative efficacy of bimekizumab 320 mg every 2 weeks/every 4 weeks (Q2W/Q4W) in moderate-to-severe HS compared with biologic therapies (secukinumab 300 mg Q2W and Q4W and adalimumab 40 mg every week [QW]) at Week 48-52. METHODS: Relevant trials were identified as part of a systematic literature review. Individual patient data for bimekizumab trials (BE HEARD I/II; Week 48) were combined and subsequently weighted to match aggregate baseline characteristics of trials for secukinumab (SUNRISE/SUNSHINE; Week 52) and adalimumab (PIONEER I/II; Week 48). Weights for patients receiving bimekizumab were determined using a propensity score model. Unanchored comparisons of reweighted bimekizumab and comparator data for key HS efficacy outcomes were analysed. RESULTS: Bimekizumab Q2W/Q4W demonstrated significantly higher odds of response for all HS Clinical Response (HiSCR) and HS Severity Score System (IHS4) outcomes compared with secukinumab Q4W, including HiSCR50 (odds ratio [OR]: 2.68; 95% confidence interval [CI]: 1.71, 4.19), HiSCR75 (OR: 2.20; 95% CI: 1.48, 3.26) and IHS4-55 (OR: 2.27; 95% CI: 1.48, 3.48); and for HiSCR50/75 compared with adalimumab QW (OR: 2.57; 95% CI: 1.48, 4.44/OR: 1.84; 95% CI: 1.08, 3.13, respectively). CONCLUSION: Compared with other approved biologics, bimekizumab showed favourable efficacy across the majority of outcomes assessed at Week 48-52, indicating its potential as a durable long-term therapeutic option for patients with moderate-to-severe HS.