Abstract
Despite advancements in psoriasis therapeutics, biologic discontinuation and switching still happen frequently, with the most common reasons being lack of efficacy or treatment intolerance. Conventional teaching has been to switch out of the class (inter-class switching) for primary non-responders and to stay in the class (intra-class switching) for secondary non-responders. Previous real-world studies have reported success with intra-class switching within the IL-17 inhibitor class, but data have been limited to secukinumab, ixekizumab, and brodalumab. Using retrospective data from cases selected for moderate-to-severe psoriasis who failed prior IL-17 therapy, we report our real-world experience using bimekizumab in 50 patients who failed a prior IL-17 inhibitor, in which 82% achieved an IGA 0/1. By demonstrating achievement of stringent benchmarks, such as IGA 0/1 and sPGAxBSA 100 in these selected patients, we challenge the conventional teaching of primary vs secondary non-responders class switching, and have found bimekizumab to be a viable option in those who have failed IL-17 inhibitor therapy in the past.