# Real-Life Effectiveness and Safety of Bimekizumab in Plaque Psoriasis Involving Difficult-to-Treat Areas: A 52-Week, Retrospective Real-World, Single-Center Study

## TL;DR

This study shows that bimekizumab is effective and safe for treating psoriasis in hard-to-treat body areas over a year.

## Contribution

The study provides real-world evidence of bimekizumab's effectiveness in psoriasis areas like the scalp and nails.

## Key findings

- 90.6% of patients achieved clear or almost clear psoriasis on the scalp after 52 weeks.
- Bimekizumab showed sustained improvement in all difficult-to-treat areas with a favorable safety profile.
- Oral candidiasis was the most common adverse event, occurring in 11.8% of patients.

## Abstract

Background: Psoriasis is a chronic inflammatory disease that frequently affects difficult-to-treat areas such as the scalp, nails, genitalia, and palms/soles, with significant physical and psychological burden. Bimekizumab, a monoclonal antibody targeting both interleukin (IL)-17A and IL-17F, has shown rapid and durable efficacy in clinical trials, but real-world data in these subgroups remain limited. Methods: We performed a 52-week, single-center retrospective study including patients with psoriasis involving at least one difficult-to-treat area. Effectiveness was assessed using site-specific Physician’s Global Assessment (sc-PGA, f-PGA, sPGA-G, pp-PGA). The primary endpoint was the proportion of patients achieving a PGA 0/1 (clear or almost clear). Safety data were collected at each visit. Results: Eighty-five patients were included (61.8% male; mean age 48.1 years; mean Body Mass Index (BMI, 26.9 kg/m2). Difficult-to-treat areas involved were the scalp (70.6%), nails (41.2%), genitalia (27.1%), and palms/soles (24.7%). At week 52, sc-PGA 0/1 was achieved in 90.6% of patients, sPGA-G 0/1 in 81.3%, f-PGA 0/1 in 66.7%, and pp-PGA 0/1 in 87.5%. Mean PGA values progressively decreased across all sites. The most common adverse event was oral candidiasis (11.8%). Conclusions: Bimekizumab showed rapid, sustained, and clinically meaningful improvement across all difficult-to-treat areas with a favorable safety profile.