When a new treatment is approved, the immediate question from patients is: how long does it work? Two-year data from the BE HEARD trials, published in the Journal of the European Academy of Dermatology and Venereology in February 2026, provide the most comprehensive answer yet for bimekizumab (Bimzelx). The results are encouraging: the majority of patients who responded to bimekizumab in the first year maintained their improvements through two years of treatment.
What the Two-Year Data Show
The two-year analysis examined patients from the BE HEARD I and BE HEARD II trials who had responded to bimekizumab at week 16 and continued treatment. The key findings were as follows.
| Outcome | Percentage of Initial Responders Maintaining at 2 Years |
|---|---|
| Overall improvement maintained | >85% |
| HiSCR50 sustained | 90% |
| Quality of life improvement (DLQI) maintained | 86% |
These durability figures are clinically significant. For context, adalimumab (the first approved HS biologic) shows secondary loss of response in a meaningful proportion of patients over time, often due to the development of anti-drug antibodies. The bimekizumab two-year data suggest a more durable response, though longer-term data and real-world evidence will be needed to fully characterize its durability profile.
IHS4 Outcomes: A More Comprehensive Measure
The February 2026 publication also reported outcomes using the IHS4 (International Hidradenitis Suppurativa Severity Score System), a more comprehensive disease severity measure than HiSCR50 alone. IHS4 accounts for the number and type of lesions (nodules, abscesses, and draining tunnels) and provides a more granular picture of disease activity. The bimekizumab IHS4 data showed consistent improvement across all lesion types through two years.
What About Oral Thrush?
Oral candidiasis (thrush) was the most notable side effect of bimekizumab in the initial trials. The two-year data showed that the rate of oral candidiasis was highest in the first year of treatment and decreased in the second year, suggesting that patients who tolerate the drug through the first year are less likely to experience this side effect over time. Most cases remained mild and manageable with antifungal treatment.
Real-World Evidence: What Comes Next
Clinical trial data, while rigorous, represent a selected patient population under controlled conditions. Real-world evidence studies are now underway to evaluate how bimekizumab performs in routine clinical practice, including in patients with more complex disease, comorbidities, and prior biologic failures. These studies will be important for understanding how the two-year trial data translate to everyday clinical use.
What This Means for Patients Considering Bimekizumab
The two-year durability data strengthen the case for bimekizumab as a long-term treatment option for moderate-to-severe HS. Combined with the 2025 network meta-analysis that ranked it as the most efficacious approved biologic, and the monthly maintenance dosing schedule after the initial 16-week phase, bimekizumab is increasingly positioned as a first-choice biologic for patients who are starting biologic therapy for the first time. For patients who have previously tried adalimumab or secukinumab without adequate response, the two-year data suggest that switching to bimekizumab can produce durable improvements.