Comparative Effectiveness of Bimekizumab in Psoriatic Arthritis: A Model‐Based Meta‐Analysis of American College of Rheumatology Response Criteria

Abstract

A model‐based meta‐analysis (MBMA) was conducted to compare the efficacy of bimekizumab with other psoriatic arthritis (PsA) treatment regimens using ≥20%/50%/70% improvements in American College of Rheumatology (ACR) criteria (ACR20/50/70) for patients with PsA. Forty‐nine trials of 16 drugs were identified in the literature, comprising 21,340 patients. Trial‐level covariates including prior biologic use, concomitant methotrexate use, time since diagnosis, trial completion year, and active comparator were considered for exploratory models. The final model was selected using leave‐one‐out cross‐validation (LOO CV) to assess predictive performance based on prespecified criteria. LOO CV was conducted for 15 trials; the final model demonstrated that 91.5% (952/1,040) of the observed treatment differences, and 96.1% of the observed ACR20/50/70 response rates were within the 95% prediction interval (PI). Median ACR50 response rates (95% PI) at Week 16 in biologic‐naïve patients were predicted to be 44% (40–49%) for bimekizumab 160 mg, amongst the highest of all treatments analyzed. Response rates for secukinumab 150 mg and risankizumab 150 mg were 28% (25–32%) and 27% (24–‍31%), respectively. The MBMA was also used to predict the probability of success (PoS) of potential head‐to‐head trials using ACR50 response as the endpoint with varying sample sizes: versus secukinumab 150 mg, the PoS for bimekizumab 160 mg was 62% (N=200) and 90% (N=400). Versus risankizumab 150 mg, the PoS for bimekizumab 160 mg was 68% (N=200) and 94% (N=400). In summary, a predictive MBMA described ACR20/50/70 outcomes in PsA, allowing accurate and precise treatment comparisons and robust PoS calculations.