Bimekizumab is used to treat inflammatory conditions such as ankylosing spondylitis (AS), non-radiographic axial spondyloarthritis, psoriatic arthritis (PsA), and psoriasis. It works by binding to an inflammatory cytokine called IL-17A and IL-17F to reduce inflammation. Since it affects the immune system, it can also increase the risk of infections.
Bimekizumab is used to treat inflammatory types of arthritis, such as ankylosing spondylitis (AS), non-radiographic axial spondyloarthritis, and psoriatic arthritis (PsA). It is also used to treat psoriasis.
The usual dose of bimekizumab is 160 mg given once every four weeks. In some cases, where psoriasis is also being treated, it may be given as 320mg every four weeks to start, followed by 320mg every 8 weeks. The 320mg dose requires two injections of 160mg injected at separate sites on the skin.
The medication comes in a single-use pre-filled syringe or autoinjector for administration.
Bimekizumab is a biologic drug and belongs to a group of medicines called interleukin (IL) inhibitors. The proteins called IL-17A and IL-17F are present at increased levels in diseases such as psoriasis, psoriatic arthritis (PsA) and axial spondyloarthritis (AS). Bimekizumab binds to these proteins and reduces their activity leading to improved symptoms such as reduced pain and swelling, and in psoriasis reduces itching and improves the skin lesions. It can help improve day-to-day function.
As with all of the biologics, you may not feel the effects of the bimekizumab right away. Some people begin to feel the effects of the medication after 2 weeks; however, it may take three to six months to feel its full effect. It is important to be patient and keep taking your medication.
To provide symptom relief while you are waiting for bimekizumab to take effect, your healthcare provider may recommend taking a steroid, such as prednisone, or a non-steroidal anti-inflammatory drug (NSAID).
Taking bimekizumab can make it more difficult for your body to fight infections. Therefore, people with active infections should not take this medication. If you have a fever, think you may have an infection or have been prescribed an antibiotic, contact your healthcare provider. People who have had frequent infections in the past or a history of tuberculosis should discuss the use of bimekizumab with their healthcare provider.
Also contact your healthcare provider if you are having surgery as you may need to stop bimekizumab until you are healed and there is no sign of infection.
Bimekizumab has not been studied in pregnant people or lactating parents so its effect(s) on pregnant people or nursing babies are unknown. You should tell your doctor if you are pregnant or are planning to become pregnant. Because of the potential for adverse reactions in nursing infants, a decision should be made with your healthcare provider on whether or not to discontinue nursing or the medication, taking into account the importance of the drug to the lactating parent. Breastfeeding/chestfeeding is not recommended for at least five months after the last bimekizumab treatment.
Those who have had a previous allergic reaction to bimekizumab should avoid the medication.
People with a history of cancer should discuss the use of bimekizumab with their healthcare provider.
Before starting this medication, you will likely be tested for inactive (“latent”) tuberculosis (TB) and hepatitis B because abatacept can dampen the immune system and cause these infections to become active. If TB or hepatitis is found, it will need to be treated before you start bimekizumab.
Make sure that your vaccinations are up to date before starting bimekizumab. Your healthcare provider will likely recommend a number of vaccines (e.g., influenzae, pneumonia, RSV, shingles) to get beforehand. Because bimekizumab can decrease your ability to respond to vaccines, you should wait at least two to three weeks after your last vaccine before starting bimekizumab. If you are already on bimekizumab and need a vaccination, talk to your healthcare provider about vaccine spacing and whether or not you need to hold bimekizumab. Live vaccines are not recommended due to risk of causing infection. Before receiving any vaccinations while taking bimekizumab, you should speak with your healthcare provider.
Like all medications, taking bimekizumab carries some risk of side effects, which must be balanced with the potential benefits. In general, the risk of joint damage and permanent disability (resulting from arthritis) is much greater than the risks of side effects from bimekizumab. When monitored properly the vast majority of side effects are rare, most improve over time and are reversible.
As with all DMARD and biologic medications, bimekizumab can lower the ability of your immune system to fight infections and increase your risk of infections. You should take precautions to minimize your risk of being infected by common contagious infections such as COVID-19, influenzae, pneumonia, and the common cold.
The most commonly reported side effect with bimekizumab is symptoms of a cold (sore throat, stuffy nose). bimekizumab can cause a reaction (redness, pain, and itching) at the injection site. Other commonly reported symptoms include eczema and oral thrush. Talk to your healthcare provider if any of these symptoms affect you severely.
Before starting this medication, you will likely be tested for inactive (“latent”) tuberculosis (TB) and hepatitis B because bimekizumab can dampen the immune system and cause these infections to become active. If TB or hepatitis is found, it will need to be treated before you start bimekizumab.
Rarely bimekizumab can cause a serious allergic reaction (feeling faint, swelling of the face, eyelids, tongue, lips, mouth or throat, trouble breathing, chest tightness). If you have troublesome symptoms talk to your healthcare provider.
Bimekizumab must be protected from light and stored in a refrigerator (2 to 8°C, or 34 to 46°F). Do not freeze. If necessary, bimekizumab may be stored at room temperature up to 25°C / 77°F, protected from light, for a maximum of 25 days, within the expiration of the product. Do not store above 25°C / 77°F. Discard the product if it is not used within 25 days of storage at room temperature. Do not put pre-filled syringes or autoinjectors back in the refrigerator once they have reached room temperature.
Contributors
This information was last updated in June 2024 with expert review and advice by:
Alan Low, BSc(Pharm), PharmD, ACPR, FCSHP, CCD, RPh
Clinical Professor, Faculty of Pharmaceutical Sciences, University of British Columbia
Pharmacy Lead and Primary Care Pharmacist, BioPro Biologics Pharmacy
Care Director, MedInfuse Health
Garrett Tang, PharmD, RPh
Pharmacist Services Coordinator, MedInfuse Health
We also thank previous expert contributor:
Jason Kielly, BSc(Pharm), PharmD
Assistant Professor, School of Pharmacy, Memorial University of Newfoundland
Clinical Pharmacist, Rheumatic Health Program, Eastern Health
