A Study to Evaluate the Efficacy, Safety and Tolerability of Bermekimab in Patients With Hidradenitis Suppurativa

HiSCR was defined as at least 50 percent (%) reduction in total abscess and inflammatory nodule (AN) count with no increase in abscess count and no increase in draining fistula count relative to baseline.

Change from baseline in NRS for pain and itch at Weeks 12 and 16 was reported. Participants were given a take-home diary to complete each night before bed. Participants were asked to report "average pain", and "worst moment pain" as well as "average itch" and "worst moment itch" on a 0 to 10 NRS, where 0=no itch or no pain and 10=worst itch or worst pain. Higher score indicated more severity.

Change form baseline in total AN count at Weeks 12 and 16 was reported. Abscess and inflammatory nodule were counted for the hidradenitis suppurativa (HS) affected anatomical regions. The AN count is the sum of number of abscess and inflammatory nodules across anatomical regions.

Change form baseline in number of draining fistulas at Weeks 12 and 16 was reported. Draining fistula were defined as fistulas that drain serious or purulent fluid, either spontaneously or by gentle palpation.

HiSCR was defined as at least 50% reduction in AN count with no increase in abscess count and no increase in draining fistula count relative to baseline.

Change from baseline in mHSS at Weeks 12 and 16 was reported. The sartorius scale was used to quantify the severity of HS. Points were awarded for 12 body areas (left and right axillae, left and right sub/inframammary areas, intermammary area, left and right buttocks, left and right inguino-crural folds, perianal area, perineal area, and other): points were awarded for nodules (2 points for each); abscesses (4 points); fistulas (4 points); scars (1 point); other findings (1 point); and longest distance between 2 lesions (2-6 points, 0 if no lesions); and if lesions were separated by normal skin (yes: 0 points; no: 6 points). The total sartorius score was the sum of the 12 regional scores. Scale scores range from 0 to infinite, with larger scores representing higher severity of HS.

HS-PGA was physician assessment of severity of disease based on 6-point scale:Clear (0)=total number of abscesses, inflammatory nodule, non-inflammatory nodule and draining fistulas was 0;Minimal (1)=total number of abscesses,draining fistulas, inflammatory nodule was 0, presence of non-inflammatory nodule;Mild (2)=total number of abscesses, draining fistulas was 0, total number of inflammatory nodule was 1-4, or presence of 1 abscess or draining fistula and absence of any inflammatory nodules;Moderate (3)=total number of abscesses and draining fistulas was 0, total number of inflammatory nodule was at least 5; or presence of 1 abscess or draining fistula and at least 1 inflammatory nodule; or 2-5 abscesses or draining fistulas, fewer than 10 inflammatory nodule;Severe (4)=total number of abscesses or draining fistulas was 2-5, total number of inflammatory nodule was at least 10;Very severe (5)=more than 5 abscesses or draining fistulas.Higher score indicated more severity of disease.

The HADS was an instrument for screening anxiety and depression in non-psychiatric populations; repeated administration also provides information about changes in a participant's emotional state. It comprises 14 items, seven to assess anxiety (HADS-A), namely items 1, 3, 5, 7, 9, 11, and 13; and seven to assess depression (HADS-D), namely items 2, 4, 6, 8, 10, 12, and 14. Each item receives a score from 0 to 3 on a Likert Scale. The total score for each HADS-A and HADS-D scale was obtained by adding the individual scores for each item, with the maximum score 21. The presence or absence of depression and anxiety was defined, for each respective scale, based on the following cutoff values: HADS (anxiety): 0-8 equal to (=) no anxiety; greater than (>) 9 = anxiety; HADS (depression): 0-8 = no depression; >9 = depression.

DLQI was a simple, compact, and practical questionnaire to assess limitations related to the impact of skin disease. The instrument contains ten items dealing with the participant's skin. The DLQI domains include symptoms and feelings, daily activities, leisure, work and school, personal relationships, and treatment. The participant respond on a four-point scale, ranging from "Very Much" (score 3) to "Not at All" or "Not relevant" (score 0). The DLQI total score was derived by summing all item scores, which has a possible range of 0 to 30, with 30 corresponding to the worst quality of life, and 0 corresponding to the best. A lower score (that is, negative change score) indicated improvement in the Quality of Life.

The EQ-5D-3L was a standardized 2-part instrument for use as a measure of health outcome, primarily designed for self-completion by respondents. It consists of EQ-5D descriptive system and EQ visual analogue scale (VAS). EQ-5D-3L-VAS records the participant's self-rated health on a vertical VAS that allows the participants to indicate their health state that can range from 0 (worst health you can imagine) to 100 (best health you can imagine). Positive change in score indicated improvement.

The PGI-c was a single-item patient reported outcome (PRO) that assessed change in severity of skin pain due to HS. Participants rated how his/her HS had changed since the beginning of the study using a 7-point scale ranging from 1 to 7 where 1 indicates "very much better", 2 indicates "Much better', 3 indicates "A little better", 4 indicates "No change", 5 indicates "A little worse", 6 indicates "Much worse" and 7 indicates "Very much worse".

The PGI-s was a single-item PRO that assessed change in a participant's impression of their disease severity. The PGI-s item asks the respondent to best describe how his/her HS symptoms are now (that is, "check the one number that best describes how your HS symptoms are now") on a 4-point scale scored as: "normal" (1), "mild" (2), "moderate" (3), or "severe" (4)".

HSSD is a 7-item patient self-reported questionnaire that assesses 5 HS-related symptoms including pain, tenderness, hot skin feeling, odor, and itchiness. The participants were asked to rate the severity of each symptom on a 0 to 10 numerical rating scale, with 0 indicating no symptom experience and 10 indicating the worst possible symptom experience. All 5 symptoms have a recall period of the past 7 days, except for 2 additional questions on pain which evaluate current pain and pain in the past 24 hours with a score range from 0 (no symptom experience) to 10 (worst possible symptom experience). A total symptom score also ranged from 0 (no symptom) to 10 (worst possible symptom), was derived by averaging the 5 individual scale scores that utilize the past 7-day recall period. Change from baseline in HS-related pain symptom score in the past 24 hours based on HSSD was reported.

The HSSD was a 7-item patient self-reported questionnaire that assessed 5 HS-related symptoms including pain, tenderness, hot skin feeling, odor, and itchiness. The participants were asked to rate the severity of each symptom on a 0 to 10 numerical rating scale, with 0 indicating no symptom experience and 10 indicating the worst possible symptom experience. All 5 symptoms had a recall period of the past 7 days, except for 2 additional questions on pain which evaluate current pain and pain in the past 24 hours. Each individual symptom scale score, ranging from 0-10, was summarized. A total symptom score, which also ranged from 0-10, was derived by averaging the 5 individual scale scores that utilize the past 7-day recall period.

Serum concentration of bermekimab was reported. This outcome measure was planned to be analyzed for specified arms only.

Reduction from baseline in serum IL-6 was reported.