BE HEARD EXT: Bimekizumab Shows Greater Benefit With Earlier Use in HS

New pooled 2-year data indicate that patients with hidradenitis suppurativa (HS) who initiated bimekizumab earlier in their disease course achieved higher rates of stringent clinical response than those with longer-standing disease, according to a post hoc analysis discussed by Raj Chovatiya, MD, PhD.^1,2

Bimekizumab is a humanized immunoglobulin G1 monoclonal antibody that selectively inhibits interleukin (IL)-17F and IL-17A.¹ The analysis used pooled 96-week data from the phase 3 BE HEARD I and BE HEARD II trials and their open-label extension, BE HEARD EXT, stratifying patients into disease duration quartiles to explore whether earlier intervention affects long-term outcomes.

Chovatiya, founder and director of the Center for Medical Dermatology + Immunology Research and associate professor at Rosalind Franklin University Chicago Medical School, spoke in this HCPLive interview about the analysis, framing it around a window-of-opportunity hypothesis common across inflammatory diseases.

How Was the Bimekizumab Disease-Duration Analysis Designed?

Patients enrolled in BE HEARD I and II received placebo or bimekizumab before all participants transitioned to open-label bimekizumab. Those completing the initial 48-week period could enroll in the extension study, receiving bimekizumab dosed every 2 or 4 weeks based on HiSCR90 achievement. Investigators divided the cohort into disease duration quartiles: the lowest quartile included patients with roughly 2.4 years of disease or less, while the highest quartile included patients with approximately 10.7 years of disease or more.

What Did the Data Show Across Duration Quartiles?

Bimekizumab demonstrated efficacy across both the shortest and longest disease duration quartiles, consistent with prior analyses and real-world experience. However, when examining stringent efficacy thresholds, including HiSCR75, HiSCR90, and HiSCR100, as well as corresponding IHS4 response thresholds, the proportion of patients achieving these outcomes was consistently greater among those in the lowest disease duration quartile. This gap widened further as response thresholds increased, becoming most pronounced at the highest efficacy benchmarks assessed.

Disclosures: Chovatiya previously reported serving as an advisor, consultant, speaker, and/or investigator for AbbVie, Amgen, Apogee Therapeutics, Arcutis, Argenx, ASLAN Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, Eli Lilly and Company, FIDE, Formation Bio, Galderma, Genentech, GSK, Incyte, LEO Pharma, L’Oréal, Nektar Therapeutics, Novartis, Opsidio, Pfizer Inc., Regeneron, RAPT, Sanofi, Sitryx, and UCB.

References

1. Chovatiya R, Alavi A, Miyagawa T. Bimekizumab 2-year efficacy by hidradenitis suppurativa duration: BE HEARD EXT results. J Eur Acad Dermatol Venereol. https://doi.org/10.1111/jdv.70631.

2. Chovatiya R. Bimekizumab efficacy by disease duration and severity in moderate to severe hidradenitis suppurativa: 3-year phase 3 results from BE HEARD EXT. 2026. AAD. #73498.