Dual neutralisation of interleukin (IL)-17A and IL-17F with the monoclonal IgG1 antibody bimekizumab and certolizumab pegol (CZP) is effective and safe in patients with rheumatoid arthritis (RA) and inadequate response (IR) to CZP alone, according to findings published in the Annals of the Rheumatic Diseases.
The phase 2a, double-blind, proof-of-concept (PoC) study recruited patients with moderate-to-severe RA. Participants received CZP 400 mg at weeks 0, 2 and 4, and 200 mg at week 6.
Patients with IR at week 8 (Disease Activity Score 28-joint C-reactive protein (DAS28[CRP] >3.2) were randomised 2:1 to CZP 200 mg every 2 weeks (Q2W) plus bimekizumab 240 mg loading dose, then 120 mg Q2W (n=52) or CZP plus placebo (n=27).
The primary efficacy and safety variables were changed in DAS28(CRP) between weeks 8 and 20 and incidence of treatment-emergent adverse events (TEAEs).
At week 20, there was a greater reduction in DAS28(CRP) with dual treatment (99.4% posterior probability).
The most frequent TEAEs were infections and infestations (CZP plus bimekizumab, 50.0%; CZP plus placebo, 22.2%).
The authors say the findings “support the potential to further explore concomitant neutralisation of multiple pathways in other patient populations where this treatment strategy may provide additional benefits”.