Objective:

To evaluate the 2-year effectiveness, safety, and drug survival of bimekizumab in routine clinical practice, and identify predictors of complete skin clearance.

Approach:

• Study Design: A retrospective, multicenter, real-world observational study conducted across three dermatological referral centers in Italy.
• Patient Population: Included adult patients with moderate-to-severe chronic plaque psoriasis who initiated treatment with bimekizumab between April 2023 and December 2025.
• Data Collection: Clinical and demographic data were extracted from electronic medical records, including demographics, disease duration, comorbidities, and treatment details.

Key Findings:

• Bimekizumab demonstrated rapid and sustained effectiveness, with 80.0% and 76.5% of patients achieving complete skin clearance (PASI100) at week 52 and 104, respectively.
• Biologic-naïve patients had a 2-year drug survival rate of 91.5%, while prior biologic exposure decreased long-term treatment retention to 64.0%.
• Palmo-plantar involvement, nail psoriasis, and concomitant proton pump inhibitor use were identified as independent negative predictors for achieving early complete skin clearance; however, findings derived from small subgroups should be interpreted cautiously.

Interpretation:

Findings suggest that while bimekizumab is effective over two years, prior biologic exposure negatively impacts treatment retention.

Limitations:

• Findings regarding predictors of complete skin clearance derived from small subgroups should be interpreted cautiously as hypothesis-generating.

Conclusion:

Bimekizumab shows promising long-term effectiveness and safety in real-world settings for chronic plaque psoriasis.