#2-35E. Long-Term Control of Peripheral Manifestations in axSpA: Bimekizumab's Two-Year Efficacy (RMD Open, 2025)

When managing axial spondyloarthritis (axSpA), how effectively are we controlling the highly prevalent peripheral manifestations, such as enthesitis and peripheral arthritis, that significantly impact patient quality of life? This episode examines a dedicated analysis reporting the sustained effect of bimekizumab (BKZ), a monoclonal antibody selectively inhibiting both IL-17A and IL-17F, on peripheral manifestations up to 104 weeks across the full axSpA disease spectrum, including non-radiographic (nr-axSpA) and radiographic (r-axSpA) cohorts. The key finding is that BKZ resulted in rapid and substantial improvements in enthesitis and peripheral arthritis, sustained over two years. Over 40% of BKZ-treated patients achieved complete enthesitis resolution (MASES=0), and over 60% achieved complete peripheral arthritis resolution (SJC=0) by Week 104. Notably, enthesitis resolution in r-axSpA patients was associated with larger improvements in overall clinical outcomes, including spinal pain and quality of life (ASQoL). However, clinicians must interpret these promising results cautiously, as this was a post hoc analysis derived from phase III trial data and should therefore be considered exploratory. Given the high disease burden conferred by peripheral symptoms, these long-term data offer valuable evidence for optimizing treatment strategies for axSpA patients in daily practice.

Citation: Ramiro S, Poddubnyy D, Mease PJ, et al. Sustained resolution of enthesitis and peripheral arthritis over 104 weeks with bimekizumab in axial spondyloarthritis. RMD Open. 2025. DOI: 10.1136/rmdopen-2025-005969

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