Bimekizumab as-needed dosing in patients with psoriasis: a case series

INTRODUCTION: Despite significant advances in psoriasis treatment, off-label dosing studies of psoriasis biologic therapies are limited. MATERIALS AND METHODS: In this retrospective case series, medical records from 28 patients with moderate-to-severe psoriasis treated with bimekizumab during 64-week period from May 2023 to October 2024 at the Psoriasis Unit of the Grupo Jaen (Madrid, Spain), were evaluated. Patients were managed with an off-label, as-needed, dosing strategy, with all patients initially receiving two 320 mg doses of bimekizumab at Weeks 0 and 4; subsequent doses were administered only if a given patient dropped below a PASI90 response. Primary outcome was the percentage of patients that achieved and maintained optimal skin control over time, defined as achieving a PASI90 response. RESULTS: Twenty-seven out of the 28 patients achieved a PASI90 response after the first two bimekizumab doses, and all maintained PASI90 responses with as-needed dosing over time. One patient achieved PASI90 after a single dose of bimekizumab, and voluntarily decided not to receive a second dose. No adverse events were observed. CONCLUSIONS: Larger prospective studies comparing efficacy and safety of this off-label, as needed, bimekizumab dosing regimen with standard on-label dosing are necessary to corroborate these findings.