3-Year BE HEARD Data Link Bimekizumab to Fewer HS Draining Tunnels

Patients with moderate to severe hidradenitis suppurativa (HS) treated with bimekizumab (Bimzelx) for 3 years reported substantial gains in quality of life and symptom relief, regardless of how many draining tunnels they had at the start of treatment. The pooled BE HEARD data were presented at the 2026 Symposium on Hidradenitis Suppurativa Advances (SHSA) in Tucson, Arizona.¹ By year 3, about half of patients in every baseline tunnel category reported that HS had no effect on their quality of life.

Draining tunnels are linked to disease progression and drive much of the pain, itch, drainage and odor patients experience. Bimekizumab, which inhibits both interleukin (IL)-17A and IL-17F, was approved by the US Food and Drug Administration (FDA) for adults with moderate to severe HS in November 2024, based on the phase 3 BE HEARD I and BE HEARD II trials.²˒³

The analysis was led by Christopher J. Sayed, MD, of the University of North Carolina School of Medicine. His co-authors included Martina L. Porter, MD, of Beth Israel Deaconess Medical Center and Harvard Medical School, and Hessel H. van der Zee, MD, PhD, of Erasmus Medical Center.¹

How Was the BE HEARD Analysis Designed?

Investigators pooled data from BE HEARD I and II and the open-label BE HEARD EXT study. Of 868 patients randomly assigned to bimekizumab 320 mg at baseline, 556 entered the extension and continued treatment. Results are reported as observed cases through year 3 (148 weeks).¹

Patients were grouped by baseline draining tunnel count: 0, 1 to 2, 3 to 5 or more than 5. At baseline, the mean age was 36.3 years, 53.8% of patients were female, the mean draining tunnel count was 3.8 and 45.5% had Hurley stage III disease.¹ Outcomes included the HS Quality of Life (HiSQOL) total score and individual items from the HS Symptom Questionnaire (HSSQ).

How Did Draining Tunnels and Quality of Life Change Over 3 Years?

The share of patients with no draining tunnels rose from 23.6% at baseline to 68.7% (252/367) at year 3. The share with more than 5 tunnels fell from 23.2% to 4.1% (15/367).¹

At baseline, 1.4% to 6.1% of patients across tunnel groups had a HiSQOL total score of 4 or lower, meaning HS had no impact on their quality of life.¹ At year 3, the rates were:

• 43.8% (32/73) for patients with no baseline tunnels
• 46.9% (46/98) for 1 to 2 tunnels
• 50.5% (50/99) for 3 to 5 tunnels
• 46.7% (42/90) for more than 5 tunnels

Which HS Symptoms Improved With Bimekizumab?

In every tunnel category, the proportion of patients scoring 0 on each HSSQ symptom item was no higher than 12.2% at baseline and rose to similar levels across groups by year 3.¹ At year 3, the share of patients with no symptoms was:

• 31.6% to 44.4% for skin pain
• 24.7% to 30.3% for itch
• 26.7% to 39.4% for drainage or oozing
• 33.3% to 42.4% for smell or odor

At baseline, these rates had ranged from 0% to 3.1% for skin pain and 0.8% to 10.7% for drainage.¹ The authors concluded that the results show long-term benefit and reduced cumulative disease burden with bimekizumab.

The observed-case analysis includes only patients who stayed on treatment, and the open-label extension had no comparator arm. UCB funded the study, and 4 of the 12 authors are UCB employees.¹

Editor’s Note: This summary has been edited for grammar and clarity using artificial intelligence tools.

References

1. Sayed CJ, Porter ML, Weisman J, et al. Bimekizumab improves patient-reported outcomes regardless of baseline DT count: 3-year BE HEARD trial. Presented at: Symposium on Hidradenitis Suppurativa Advances; November 6-8, 2026; Tucson, AZ.

2. Kimball AB, Jemec GBE, Sayed CJ, et al. Efficacy and safety of bimekizumab in patients with moderate-to-severe hidradenitis suppurativa (BE HEARD I and BE HEARD II): two 48-week, randomised, double-blind, placebo-controlled, multicentre phase 3 trials. Lancet. 2024;403(10443):2504-2519. doi:10.1016/S0140-6736(24)00101-6.

3. Smith T. FDA approves bimekizumab for adults with hidradenitis suppurativa. HCPLive. Published November 20, 2024. Accessed November 10, 2026. https://www.hcplive.com/view/fda-approves-bimekizumab-adults-with-hidradenitis-suppurativa.