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    Clinical Trial Results:
    A MULTICENTER, PHASE 2B, RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED, PARALLEL-GROUP, DOSE-RANGING STUDY TO EVALUATE THE EFFICACY AND SAFETY OF BIMEKIZUMAB IN SUBJECTS WITH ACTIVE ANKYLOSING SPONDYLITIS

    Summary
    EudraCT number
    		 2016-001102-42
    Trial protocol
    		 HU   ES   CZ   DE   BG   GB  
    Global end of trial date
    30 Aug 2018

    Results information
    Results version number
    		 v2(current)
    This version publication date
    02 Dec 2020
    First version publication date
    21 Sep 2019
    Other versions
    		 v1
    Version creation reason
    • Correction of full data set
    Alignment with final posting on ClinicalTrials.gov after NIH review.

    Trial information

    		 Close Top of page
    Trial identification
    Sponsor protocol code
    AS0008
    Additional study identifiers
    ISRCTN number
    		 -
    US NCT number
    		 NCT02963506
    WHO universal trial number (UTN)
    		 -
    Sponsors
    Sponsor organisation name
    UCB Biopharma SPRL
    Sponsor organisation address
    Allée de la Recherche 60, Brussels, Belgium, 1070
    Public contact
    Clin Trial Reg & Results Disclosure, UCB BIOSCIENCES GmbH, clinicaltrials@ucb.com
    Scientific contact
    Clin Trial Reg & Results Disclosure, UCB BIOSCIENCES GmbH, clinicaltrials@ucb.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    12 Feb 2019
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Aug 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Assess the dose-response based on the efficacy of bimekizumab
    Protection of trial subjects
    During the conduct of the study all subjects were closely monitored.
    Background therapy
    		 Background therapy as permitted in the protocol.
    Evidence for comparator
    		 Not Applicable
    Actual start date of recruitment
    27 Oct 2016
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    		 Safety
    Long term follow-up duration
    		 4 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Bulgaria: 9
    Country: Number of subjects enrolled
    Canada: 2
    Country: Number of subjects enrolled
    Czech Republic: 96
    Country: Number of subjects enrolled
    Germany: 13
    Country: Number of subjects enrolled
    Hungary: 7
    Country: Number of subjects enrolled
    Poland: 100
    Country: Number of subjects enrolled
    Russian Federation: 34
    Country: Number of subjects enrolled
    Spain: 9
    Country: Number of subjects enrolled
    Ukraine: 21
    Country: Number of subjects enrolled
    United States: 12
    Worldwide total number of subjects
    303
    EEA total number of subjects
    234
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    291
    From 65 to 84 years
    12
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    		 The study started to enroll participants in October 2016 and concluded in August 2018.

    Pre-assignment
    Screening details
    		 The study included a 28-Day Screening Period, followed by a Double-Blind Period from Day 1 to Week 12, prior to treatment re-randomization, a Dose-blind Period, from Week 12 after the treatment re-randomization and up to Week 48 and a Safety Follow-Up (SFU) Period, post Week 48. The Participant Flow refers to the Randomized Set and Dose-Blind Set.

    Period 1
    Period 1 title
    Double-Blind Period
    Is this the baseline period?
    		 Yes
    Allocation method
    Randomised - controlled
    Blinding used
    		 Double blind
    Roles blinded
    		 Assessor, Investigator, Subject

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    		 Placebo
    Arm description
    		 Participants received placebo during the 12 weeks Double-Blind Period.
    Arm type
    		 Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    PBO
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered placebo, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 BKZ 16 mg
    Arm description
    		 Participants received bimekizumab (BKZ) 16 milligrams (mg) every 4 weeks (Q4W) during the 12 weeks Double-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 BKZ 64 mg
    Arm description
    		 Participants received bimekizumab (BKZ) 64 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 BKZ 160 mg
    Arm description
    		 Participants received bimekizumab (BKZ) 160 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period followed by the same dose during the 36 weeks Dose-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 BKZ 320 mg
    Arm description
    		 Participants received bimekizumab (BKZ) 320 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period followed by the same dose during the 36 weeks Dose-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Number of subjects in period 1
    		Placebo BKZ 16 mg BKZ 64 mg BKZ 160 mg BKZ 320 mg
    Started
    60
    61
    61
    60
    61
    Completed Double-Blind Period
    60
    59
    59
    58
    61
    Completed Week 12 - started Dose-Blind
    60
    58
    59
    58
    61
    Completed
    60
    58
    59
    58
    61
    Not completed
    0
    3
    2
    2
    0
         Adverse event, serious fatal
    -
    -
    -
    1
    -
         Consent withdrawn by subject
    -
    -
    1
    1
    -
         Adverse event, non-fatal
    -
    -
    1
    -
    -
         Adverse event, non fatal after Wk12
    -
    1
    -
    -
    -
         Lost to follow-up
    -
    1
    -
    -
    -
         No compliance
    -
    1
    -
    -
    -
    Period 2
    Period 2 title
    Dose-Blind Period
    Is this the baseline period?
    		 No
    Allocation method
    Randomised - controlled
    Blinding used
    		 Double blind
    Roles blinded
    		 Assessor, Investigator, Subject

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    		 Placebo - BKZ 160 mg
    Arm description
    		 After the 12 weeks Double-Blind Period participants randomized to placebo were re-randomized to receive bimekizumab (BKZ) 160 mg every 4 weeks (Q4W) for 36 weeks in the Dose-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 Placebo - BKZ 320 mg
    Arm description
    		 After the 12 weeks Double-Blind Period participants randomized to placebo were re-randomized to receive bimekizumab (BKZ) 320 mg every 4 weeks (Q4W) for 36 weeks in the Dose-Blind Period
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 BKZ 16 mg - BKZ 160 mg
    Arm description
    		 After the 12 weeks Double-Blind Period participants randomized to bimekizumab (BKZ) 16 mg every 4 weeks (Q4W) were re-randomized to receive BKZ 160 mg Q4W for 36 weeks in the Dose-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 BKZ 16 mg - BKZ 320 mg
    Arm description
    		 After the 12 weeks Double-Blind Period participants randomized to bimekizumab (BKZ) 16 mg every 4 weeks (Q4W) were re-randomized to receive BKZ 320 mg Q4W for 36 weeks in the Dose-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 BKZ 64 mg - BKZ 160 mg
    Arm description
    		 After the 12 weeks Double-Blind Period participants randomized to bimekizumab (BKZ) 64 mg every 4 weeks (Q4W) were re-randomized to receive BKZ 160 mg Q4W for 36 weeks in the Dose-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 BKZ 64 mg - BKZ 320 mg
    Arm description
    		 After the 12 weeks Double-Blind Period participants randomized to bimekizumab (BKZ) 64 mg every 4 weeks (Q4W) were re-randomized to receive BKZ 320 mg Q4W for 36 weeks in the Dose-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 BKZ 160 mg - BKZ 160 mg
    Arm description
    		 Participants randomized to bimekizumab (BKZ) 160 mg every 4 weeks (Q4W) in the 12 weeks Double-Blind Period, continued to receive BKZ 160 mg Q4W in the 36 weeks Dose-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Arm title
    		 BKZ 320 mg - BKZ 320 mg
    Arm description
    		 Participants randomized to bimekizumab (BKZ) 320 mg every 4 weeks (Q4W) in the 12 weeks Double-Blind Period, continued to receive BKZ 320 mg Q4W in the 36 weeks Dose-Blind Period.
    Arm type
    		 Experimental

    Investigational medicinal product name
    Bimekizumab
    Investigational medicinal product code
    BKZ
    Other name
    UCB4940
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants were administered different BKZ dose regimens, as 2 subcutaneous injections, in the lateral abdominal wall, or upper outer thigh.

    Number of subjects in period 2
    		Placebo - BKZ 160 mg Placebo - BKZ 320 mg BKZ 16 mg - BKZ 160 mg BKZ 16 mg - BKZ 320 mg BKZ 64 mg - BKZ 160 mg BKZ 64 mg - BKZ 320 mg BKZ 160 mg - BKZ 160 mg BKZ 320 mg - BKZ 320 mg
    Started
    24
    36
    31
    27
    34
    25
    58
    61
    Completed
    20
    31
    26
    24
    30
    24
    56
    54
    Not completed
    4
    5
    5
    3
    4
    1
    2
    7
         Consent withdrawn by subject
    1
    2
    2
    -
    1
    -
    -
    -
         Adverse event, non-fatal
    1
    3
    2
    2
    2
    1
    1
    6
         Lost to follow-up
    1
    -
    -
    1
    -
    -
    1
    -
         Sponsor decision
    1
    -
    -
    -
    -
    -
    -
    -
         Meeting exclusion criteria 9
    -
    -
    -
    -
    -
    -
    -
    1
         Lack of efficacy
    -
    -
    1
    -
    1
    -
    -
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo
    Reporting group description
    		 Participants received placebo during the 12 weeks Double-Blind Period.

    Reporting group title
    BKZ 16 mg
    Reporting group description
    		 Participants received bimekizumab (BKZ) 16 milligrams (mg) every 4 weeks (Q4W) during the 12 weeks Double-Blind Period.

    Reporting group title
    BKZ 64 mg
    Reporting group description
    		 Participants received bimekizumab (BKZ) 64 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period.

    Reporting group title
    BKZ 160 mg
    Reporting group description
    		 Participants received bimekizumab (BKZ) 160 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period followed by the same dose during the 36 weeks Dose-Blind Period.

    Reporting group title
    BKZ 320 mg
    Reporting group description
    		 Participants received bimekizumab (BKZ) 320 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period followed by the same dose during the 36 weeks Dose-Blind Period.

    Reporting group values
    		 Placebo BKZ 16 mg BKZ 64 mg BKZ 160 mg BKZ 320 mg Total
    Number of subjects
    		 60 61 61 60 61 303
    Age categorical
    Units: Subjects
        <=18 years
    		 0 0 0 0 0 0
        Between 18 and 65 years
    		 60 56 59 56 60 291
        >=65 years
    		 0 5 2 4 1 12
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    		 39.65 ± 10.30 43.31 ± 12.59 40.41 ± 10.93 42.38 ± 13.11 45.02 ± 11.39 -
    Gender categorical
    Units: Subjects
        Male
    		 49 53 52 52 50 256
        Female
    		 11 8 9 8 11 47

    End points

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    End points reporting groups
    Reporting group title
    Placebo
    Reporting group description
    		 Participants received placebo during the 12 weeks Double-Blind Period.

    Reporting group title
    BKZ 16 mg
    Reporting group description
    		 Participants received bimekizumab (BKZ) 16 milligrams (mg) every 4 weeks (Q4W) during the 12 weeks Double-Blind Period.

    Reporting group title
    BKZ 64 mg
    Reporting group description
    		 Participants received bimekizumab (BKZ) 64 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period.

    Reporting group title
    BKZ 160 mg
    Reporting group description
    		 Participants received bimekizumab (BKZ) 160 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period followed by the same dose during the 36 weeks Dose-Blind Period.

    Reporting group title
    BKZ 320 mg
    Reporting group description
    		 Participants received bimekizumab (BKZ) 320 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period followed by the same dose during the 36 weeks Dose-Blind Period.
    Reporting group title
    Placebo - BKZ 160 mg
    Reporting group description
    		 After the 12 weeks Double-Blind Period participants randomized to placebo were re-randomized to receive bimekizumab (BKZ) 160 mg every 4 weeks (Q4W) for 36 weeks in the Dose-Blind Period.

    Reporting group title
    Placebo - BKZ 320 mg
    Reporting group description
    		 After the 12 weeks Double-Blind Period participants randomized to placebo were re-randomized to receive bimekizumab (BKZ) 320 mg every 4 weeks (Q4W) for 36 weeks in the Dose-Blind Period

    Reporting group title
    BKZ 16 mg - BKZ 160 mg
    Reporting group description
    		 After the 12 weeks Double-Blind Period participants randomized to bimekizumab (BKZ) 16 mg every 4 weeks (Q4W) were re-randomized to receive BKZ 160 mg Q4W for 36 weeks in the Dose-Blind Period.

    Reporting group title
    BKZ 16 mg - BKZ 320 mg
    Reporting group description
    		 After the 12 weeks Double-Blind Period participants randomized to bimekizumab (BKZ) 16 mg every 4 weeks (Q4W) were re-randomized to receive BKZ 320 mg Q4W for 36 weeks in the Dose-Blind Period.

    Reporting group title
    BKZ 64 mg - BKZ 160 mg
    Reporting group description
    		 After the 12 weeks Double-Blind Period participants randomized to bimekizumab (BKZ) 64 mg every 4 weeks (Q4W) were re-randomized to receive BKZ 160 mg Q4W for 36 weeks in the Dose-Blind Period.

    Reporting group title
    BKZ 64 mg - BKZ 320 mg
    Reporting group description
    		 After the 12 weeks Double-Blind Period participants randomized to bimekizumab (BKZ) 64 mg every 4 weeks (Q4W) were re-randomized to receive BKZ 320 mg Q4W for 36 weeks in the Dose-Blind Period.

    Reporting group title
    BKZ 160 mg - BKZ 160 mg
    Reporting group description
    		 Participants randomized to bimekizumab (BKZ) 160 mg every 4 weeks (Q4W) in the 12 weeks Double-Blind Period, continued to receive BKZ 160 mg Q4W in the 36 weeks Dose-Blind Period.

    Reporting group title
    BKZ 320 mg - BKZ 320 mg
    Reporting group description
    		 Participants randomized to bimekizumab (BKZ) 320 mg every 4 weeks (Q4W) in the 12 weeks Double-Blind Period, continued to receive BKZ 320 mg Q4W in the 36 weeks Dose-Blind Period.

    Subject analysis set title
    Placebo (FAS)
    Subject analysis set type
    		 Full analysis
    Subject analysis set description
    Participants received placebo during the 12 weeks Double-Blind Period, forming the Full Analysis Set (FAS).

    Subject analysis set title
    BKZ 16 mg (FAS)
    Subject analysis set type
    		 Full analysis
    Subject analysis set description
    Participants received bimekizumab (BKZ) 16 milligrams (mg) every 4 weeks (Q4W) during the 12 weeks Double-Blind Period, forming the Full Analysis Set (FAS).

    Subject analysis set title
    BKZ 64 mg (FAS)
    Subject analysis set type
    		 Full analysis
    Subject analysis set description
    Participants received bimekizumab (BKZ) 64 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period, forming the Full Analysis Set (FAS).

    Subject analysis set title
    BKZ 160 mg (FAS)
    Subject analysis set type
    		 Full analysis
    Subject analysis set description
    Participants received bimekizumab (BKZ) 160 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period followed by the same dose during the 36 weeks Dose-Blind Period, forming the Full Analysis Set (FAS).

    Subject analysis set title
    BKZ 320 mg (FAS)
    Subject analysis set type
    		 Full analysis
    Subject analysis set description
    Participants received bimekizumab (BKZ) 320 mg every 4 weeks (Q4W) during the 12 weeks Double-Blind Period followed by the same dose during the 36 weeks Dose-Blind Period, forming the Full Analysis Set (FAS).

    Subject analysis set title
    Placebo (SS) - up to Wk 12
    Subject analysis set type
    		 Safety analysis
    Subject analysis set description
    This arm consisted of all participants who received placebo at any time in the study (up to Week 12). Participants formed the Safety Set (SS).

    Subject analysis set title
    BKZ 16 mg (SS) - up to Wk 12
    Subject analysis set type
    		 Safety analysis
    Subject analysis set description
    This arm consisted of all participants who received bimekizumab (BKZ) 16 milligrams (mg) every 4 weeks (Q4W) at any time in the study (up to Week 12). Participants formed the SS.

    Subject analysis set title
    BKZ 64 mg (SS) - up to Wk 12
    Subject analysis set type
    		 Safety analysis
    Subject analysis set description
    This arm consisted of all participants who received bimekizumab (BKZ) 64 mg every 4 weeks (Q4W) at any time in the study (up to Week 12). Participants formed the SS.

    Subject analysis set title
    BKZ 160 mg (SS) - up to Wk 73
    Subject analysis set type
    		 Safety analysis
    Subject analysis set description
    This arm consisted of all participants who received bimekizumab (BKZ) 160 mg every 4 weeks (Q4W) at any time in the study (up to Week 73). Participants formed the SS.

    Subject analysis set title
    BKZ 320 mg (SS) - up to Wk 73
    Subject analysis set type
    		 Safety analysis
    Subject analysis set description
    This arm consisted of all participants who received bimekizumab (BKZ) 320 mg every 4 weeks (Q4W) at any time in the study (up to Week 73). Participants formed the SS.

    Primary: Percentage of participants with Axial Spondyloarthritis International Society 40% response criteria (ASAS40) at Week 12

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    End point title
    		 Percentage of participants with Axial Spondyloarthritis International Society 40% response criteria (ASAS40) at Week 12
    End point description
    The ASAS40 response was defined as relative improvements of at least 40% and absolute improvement of at least 2 units on a 0 to 10 Numeric Rating Scale (NRS), where 0 is “not active” and 10 is “very active” in at least 3 of the 4 domains: Patient's Global Assessment of Disease Activity (PGADA), Pain assessment (total spinal pain NRS score), Function (Bath Ankylosing Spondylitis Functional Index (BASFI)), Inflammation (mean of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) questions 5 and 6 concerning morning stiffness intensity and duration) and no worsening at all in the remaining domain. Note: Participants with missing data or who discontinue study treatment prior to Week 12 were counted as non-responders. The FAS consisted of all randomized participants who received at least 1 dose of investigational medicinal product (IMP) and had a valid measurement of the primary efficacy variable at Baseline.
    End point type
    Primary
    End point timeframe
    Week 12
    End point values
    		 Placebo (FAS) BKZ 16 mg (FAS) BKZ 64 mg (FAS) BKZ 160 mg (FAS) BKZ 320 mg (FAS)
    Number of subjects analysed
    60
    61
    61
    60
    61
    Units: percentage of participants
        number (not applicable)
    13.3
    29.5
    42.6
    46.7
    45.9
    Statistical analysis title
    		 Statistical analysis 1
    Statistical analysis description
    Statistic and p-value were calculated using a Cochran-Mantel-Haenszel test (test for non-zero correlation statistic) based on modified ridit scores and including geographic region and prior Tumor Necrosis Factor (TNF) inhibitor exposure as stratification factors. Note: 999 and 0% CI are used as placeholders. Using this methodology no point estimator will be calculated. The respective correlation statistic was 17.9.
    Comparison groups
    Placebo (FAS) v BKZ 16 mg (FAS) v BKZ 64 mg (FAS) v BKZ 160 mg (FAS) v BKZ 320 mg (FAS)
    Number of subjects included in analysis
    303
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001
    Method
    		 Cochran-Mantel-Haenszel
    Parameter type
    		 Correlation statistic
    Point estimate
    999
    Confidence interval
         level
    		 0%
         sides
    2-sided
         lower limit
    		 999
         upper limit
    		 999
    Statistical analysis title
    		 Statistical analysis 2
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior tumor necrosis factor (TNF) inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 16 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other [1]
    P-value
    		 = 0.04 [2]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    2.6
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 1.04
         upper limit
    		 6.48
    Notes
    [1] - The pairwise testing of each bimekizumab dose versus placebo accounted for multiplicity by using a fixed sequence testing procedure with each bimekizumab dose being tested sequentially from the highest dose to the lowest dose. If the sequential testing failed to reach significance at a significance level of alpha=0.05, then the pairwise testing continued and the comparison was seen as non-significant.
    [2] - The p-values were displayed as nominal p-values.
    Statistical analysis title
    		 Statistical analysis 3
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 64 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other [3]
    P-value
    		 = 0.001 [4]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    4.5
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 1.83
         upper limit
    		 10.86
    Notes
    [3] - The pairwise testing of each bimekizumab dose versus placebo accounted for multiplicity by using a fixed sequence testing procedure with each bimekizumab dose being tested sequentially from the highest dose to the lowest dose. If the sequential testing failed to reach significance at a significance level of alpha=0.05, then the pairwise testing continued and the comparison was seen as non-significant.
    [4] - The p-values were displayed as nominal p-values.
    Statistical analysis title
    		 Statistical analysis 4
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 160 mg (FAS)
    Number of subjects included in analysis
    120
    Analysis specification
    Pre-specified
    Analysis type
    		 other [5]
    P-value
    		 < 0.001 [6]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    5.5
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 2.27
         upper limit
    		 13.48
    Notes
    [5] - The pairwise testing of each bimekizumab dose versus placebo accounted for multiplicity by using a fixed sequence testing procedure with each bimekizumab dose being tested sequentially from the highest dose to the lowest dose. If the sequential testing failed to reach significance at a significance level of alpha=0.05, then the pairwise testing continued and the comparison was seen as non-significant.
    [6] - The p-values were displayed as nominal p-values.
    Statistical analysis title
    		 Statistical analysis 5
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 320 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other [7]
    P-value
    		 < 0.001 [8]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    5.3
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 2.19
         upper limit
    		 12.92
    Notes
    [7] - The pairwise testing of each bimekizumab dose versus placebo accounted for multiplicity by using a fixed sequence testing procedure with each bimekizumab dose being tested sequentially from the highest dose to the lowest dose. If the sequential testing failed to reach significance at a significance level of alpha=0.05, then the pairwise testing continued and the comparison was seen as non-significant.
    [8] - The p-values were displayed as nominal p-values.

    Secondary: Change from Baseline in Ankylosing Spondylitis Disease Activity Score - C-Reactive Protein (ASDAS [CRP]) at Week 12

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    End point title
    		 Change from Baseline in Ankylosing Spondylitis Disease Activity Score - C-Reactive Protein (ASDAS [CRP]) at Week 12
    End point description
    The ASDAS was the sum of the following: 0.121xBack pain (BASDAI Q2 result) 0.058xDuration of morning stiffness (BASDAI Q6 result) 0.110xPGADA 0.073xPeripheral pain/swelling (BASDAI Q3 result) 0.579x(ln(hs-CRP [mg/L]+1)) Back pain, PGADA, duration of morning stiffness, peripheral pain/swelling and fatigue are assessed on a numerical scale (0-10 units). The change from Baseline is calculated, a '-' value indicating improvement and a '+' one worsening. There is a minimum score of 0.636 for the total ASDAS score, but no defined upper score as CRP does not have an upper limit. If a component for the ASDAS-CRP was missing at a given visit that component was imputed by carrying the last observation forward and the ASDAS-CRP was calculated accordingly. If the hs-CRP value was <2 mg/L, then it was imputed as the constant value of 2 mg/L. The FAS consisted of all randomized participants who received at least 1 dose of IMP and had a valid measurement of the primary efficacy variable at Baseline.
    End point type
    Secondary
    End point timeframe
    From Baseline to Week 12
    End point values
    		 Placebo (FAS) BKZ 16 mg (FAS) BKZ 64 mg (FAS) BKZ 160 mg (FAS) BKZ 320 mg (FAS)
    Number of subjects analysed
    60
    61
    61
    60
    61
    Units: scores on a scale
        least squares mean (standard error)
    -0.3 ± 0.17
    -0.8 ± 0.17
    -1.4 ± 0.17
    -1.3 ± 0.17
    -1.4 ± 0.17
    Statistical analysis title
    		 Statistical analysis 1
    Statistical analysis description
    Least squares (LS) Mean, standard error, confidence interval and p-value were derived using the analysis of covariance (ANCOVA) model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 16 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -0.5
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -0.86
         upper limit
    		 -0.24
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.16
    Statistical analysis title
    		 Statistical analysis 2
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 64 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -1.2
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -1.47
         upper limit
    		 -0.83
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.16
    Statistical analysis title
    		 Statistical analysis 3
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 160 mg (FAS)
    Number of subjects included in analysis
    120
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -1
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -1.35
         upper limit
    		 -0.72
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.16
    Statistical analysis title
    		 Statistical analysis 4
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 320 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -1.1
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -1.45
         upper limit
    		 -0.82
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.16

    Secondary: Percentage of participants with Axial Spondyloarthritis International Society 20% response criteria (ASAS20) at Week 12

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    End point title
    		 Percentage of participants with Axial Spondyloarthritis International Society 20% response criteria (ASAS20) at Week 12
    End point description
    The ASAS20 response was defined as an improvement of at least 20% and absolute improvement of at least 1 unit on a 0 to 10 NRS, where 0 is “not active” and 10 is “very active” in at least 3 of the 4 domains: PGADA, Pain assessment (total spinal pain NRS scores), Function (BASFI), Inflammation (mean of BASDAI questions 5 and 6 concerning morning stiffness intensity and duration) and absence of deterioration in the potential remaining domain [deterioration was defined as a relative worsening of at least 20% and an absolute worsening of at least 1 unit]. Note: Participants with missing data or who discontinue study treatment prior to Week 12 were counted as non-responders. The FAS consisted of all randomized participants who received at least 1 dose of IMP and had a valid measurement of the primary efficacy variable at Baseline.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    		 Placebo (FAS) BKZ 16 mg (FAS) BKZ 64 mg (FAS) BKZ 160 mg (FAS) BKZ 320 mg (FAS)
    Number of subjects analysed
    60
    61
    61
    60
    61
    Units: percentage of participants
        number (not applicable)
    28.3
    41.0
    62.3
    58.3
    72.1
    Statistical analysis title
    		 Statistical analysis 1
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 16 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 = 0.163 [9]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    1.7
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 0.8
         upper limit
    		 3.67
    Notes
    [9] - The p-values were displayed as nominal p-values.
    Statistical analysis title
    		 Statistical analysis 2
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 64 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001 [10]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    3.9
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 1.84
         upper limit
    		 8.48
    Notes
    [10] - The p-values were displayed as nominal p-values.
    Statistical analysis title
    		 Statistical analysis 3
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 160 mg (FAS)
    Number of subjects included in analysis
    120
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 = 0.001 [11]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    3.5
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 1.66
         upper limit
    		 7.61
    Notes
    [11] - The p-values were displayed as nominal p-values.
    Statistical analysis title
    		 Statistical analysis 4
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 320 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001 [12]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    6.5
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 2.92
         upper limit
    		 14.28
    Notes
    [12] - The p-values were displayed as nominal p-values.

    Secondary: Percentage of participants with Axial Spondyloarthritis International Society (ASAS) 5/6 response at Week 12

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    End point title
    		 Percentage of participants with Axial Spondyloarthritis International Society (ASAS) 5/6 response at Week 12
    End point description
    The ASAS 5/6 response was defined as at least 20% improvement in at least 5 of the 6 domains: PGADA, Pain assessment (total spinal pain NRS scores), Function (BASFI), Inflammation (mean of BASDAI questions 5 and 6 concerning morning stiffness intensity and duration), spinal mobility (lateral spinal flexion) and high sensitivity C-reactive protein (hs-CRP). Note: Participants with missing data or who discontinue study treatment prior to Week 12 were counted as non-responders. The FAS consisted of all randomized participants who received at least 1 dose of IMP and had a valid measurement of the primary efficacy variable at Baseline.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    		 Placebo (FAS) BKZ 16 mg (FAS) BKZ 64 mg (FAS) BKZ 160 mg (FAS) BKZ 320 mg (FAS)
    Number of subjects analysed
    60
    61
    61
    60
    61
    Units: percentage of participants
        number (not applicable)
    6.7
    29.5
    49.2
    53.3
    54.1
    Statistical analysis title
    		 Statistical analysis 1
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 16 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 = 0.003 [13]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    5.3
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 1.74
         upper limit
    		 15.96
    Notes
    [13] - The p-values were displayed as nominal p-values.
    Statistical analysis title
    		 Statistical analysis 2
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 64 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001 [14]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    11.9
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 4.03
         upper limit
    		 35.38
    Notes
    [14] - The p-values were displayed as nominal p-values.
    Statistical analysis title
    		 Statistical analysis 3
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 160 mg (FAS)
    Number of subjects included in analysis
    120
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001 [15]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    14.3
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 4.81
         upper limit
    		 42.46
    Notes
    [15] - The p-values were displayed as nominal p-values.
    Statistical analysis title
    		 Statistical analysis 4
    Statistical analysis description
    For differences in relation to placebo: Odds Ratio, confidence interval and p-value were derived from a logistic regression model including fixed effects for treatment, geographic region and prior TNF inhibitor exposure.
    Comparison groups
    Placebo (FAS) v BKZ 320 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001 [16]
    Method
    		 Regression, Logistic
    Parameter type
    		 Odds ratio (OR)
    Point estimate
    14.9
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 5.02
         upper limit
    		 44.27
    Notes
    [16] - The p-values were displayed as nominal p-values.

    Secondary: Change from Baseline to Week 12 in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)

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    End point title
    		 Change from Baseline to Week 12 in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)
    End point description
    The BASDAI is a validated self-reported instrument, which consists of six 10-unit horizontal Numeric Rating Scales (NRS) to measure severity of fatigue, spinal and peripheral joint pain and swelling, enthesitis, and morning stiffness (both severity and duration, respectively) over the last week. The final BASDAI score ranges from 0 to 10, with lower scores indicating lower disease activity. The change from Baseline is calculated, a negative value indicating improvement and a positive value worsening. Note: Missing data was imputed using multiple imputation based on the Markov-Chain Monte Carlo method for the intermittent missing data, followed by monotone regression for the monotone missing data assuming missing at random. The FAS consisted of all randomized participants who received at least 1 dose of IMP and had a valid measurement of the primary efficacy variable at Baseline.
    End point type
    Secondary
    End point timeframe
    From Baseline to Week 12
    End point values
    		 Placebo (FAS) BKZ 16 mg (FAS) BKZ 64 mg (FAS) BKZ 160 mg (FAS) BKZ 320 mg (FAS)
    Number of subjects analysed
    60
    61
    61
    60
    61
    Units: scores on a scale
        least squares mean (standard error)
    -1.0 ± 0.38
    -1.6 ± 0.38
    -2.6 ± 0.38
    -2.6 ± 0.38
    -2.9 ± 0.38
    Statistical analysis title
    		 Statistical analysis 1
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 16 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 = 0.094
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -0.6
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -1.31
         upper limit
    		 0.1
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.36
    Statistical analysis title
    		 Statistical analysis 2
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 64 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -1.6
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -2.34
         upper limit
    		 -0.91
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.37
    Statistical analysis title
    		 Statistical analysis 3
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 160 mg (FAS)
    Number of subjects included in analysis
    120
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -1.6
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -2.35
         upper limit
    		 -0.91
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.37
    Statistical analysis title
    		 Statistical analysis 4
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 320 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -1.9
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -2.6
         upper limit
    		 -1.18
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.36

    Secondary: Change from Baseline to Week 12 in the Bath Ankylosing Spondylitis Functional Index (BASFI)

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    End point title
    		 Change from Baseline to Week 12 in the Bath Ankylosing Spondylitis Functional Index (BASFI)
    End point description
    The BASFI is a validated disease-specific instrument for assessing physical function. The BASFI comprises 10 items relating to the past week. The BASFI is the mean of the 10 scores such that the total score ranges from 0 (Easy) to 10 (Impossible), with lower scores indicating better physical function. The change from Baseline is calculated, a negative value indicating improvement and a positive value worsening. Note: Missing data was imputed using multiple imputation based on the Markov-Chain Monte Carlo method for the intermittent missing data, followed by monotone regression for the monotone missing data assuming missing at random. The FAS consisted of all randomized participants who received at least 1 dose of IMP and had a valid measurement of the primary efficacy variable at Baseline.
    End point type
    Secondary
    End point timeframe
    From Baseline to Week 12
    End point values
    		 Placebo (FAS) BKZ 16 mg (FAS) BKZ 64 mg (FAS) BKZ 160 mg (FAS) BKZ 320 mg (FAS)
    Number of subjects analysed
    60
    61
    61
    60
    61
    Units: scores on a scale
        least squares mean (standard error)
    -0.7 ± 0.39
    -1.4 ± 0.38
    -1.8 ± 0.38
    -1.9 ± 0.38
    -2.2 ± 0.38
    Statistical analysis title
    		 Statistical analysis 1
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 16 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 = 0.075
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -0.6
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -1.35
         upper limit
    		 0.07
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.36
    Statistical analysis title
    		 Statistical analysis 2
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 64 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 = 0.003
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -1.1
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -1.79
         upper limit
    		 -0.37
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.36
    Statistical analysis title
    		 Statistical analysis 3
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 160 mg (FAS)
    Number of subjects included in analysis
    120
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 = 0.002
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -1.1
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -1.84
         upper limit
    		 -0.42
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.36
    Statistical analysis title
    		 Statistical analysis 4
    Statistical analysis description
    LS Mean, standard error, confidence interval and p-value were derived using the ANCOVA model with treatment, geographic region and prior TNF inhibitor exposure as fixed effects and the Baseline value as covariate.
    Comparison groups
    Placebo (FAS) v BKZ 320 mg (FAS)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    		 other
    P-value
    		 < 0.001
    Method
    		 ANCOVA
    Parameter type
    		 LS Mean Difference vs placebo
    Point estimate
    -1.5
    Confidence interval
         level
    		 95%
         sides
    2-sided
         lower limit
    		 -2.22
         upper limit
    		 -0.81
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.36

    Secondary: Percentage of participants with at least one adverse event (AE) during the study

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    End point title
    		 Percentage of participants with at least one adverse event (AE) during the study
    End point description
    An adverse event (AE) is any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. The SS consisted of all randomized participants who received at least 1 dose of IMP.
    End point type
    Secondary
    End point timeframe
    From Screening until Safety Follow-Up Visit (up to Week 77)
    End point values
    		 Placebo (SS) - up to Wk 12 BKZ 16 mg (SS) - up to Wk 12 BKZ 64 mg (SS) - up to Wk 12 BKZ 160 mg (SS) - up to Wk 73 BKZ 320 mg (SS) - up to Wk 73
    Number of subjects analysed
    60
    61
    58
    149
    150
    Units: percentage of participants
        number (not applicable)
    45.0
    44.3
    34.5
    69.8
    82.0
    No statistical analyses for this end point

    Secondary: Percentage of participants with at least one serious adverse event (SAE) during the study

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    End point title
    		 Percentage of participants with at least one serious adverse event (SAE) during the study
    End point description
    A serious adverse event (SAE) is any untoward medical occurrence that at any dose: - Results in death - Is life-threatening - Requires in patient hospitalisation or prolongation of existing hospitalisation - Is a congenital anomaly or birth defect - Is an infection that requires treatment parenteral antibiotics - Other important medical events which based on medical or scientific judgement may jeopardise the patients, or may require medical or surgical intervention to prevent any of the above. The SS consisted of all randomized participants who received at least 1 dose of IMP.
    End point type
    Secondary
    End point timeframe
    From Screening until Safety Follow-Up Visit (up to Week 77)
    End point values
    		 Placebo (SS) - up to Wk 12 BKZ 16 mg (SS) - up to Wk 12 BKZ 64 mg (SS) - up to Wk 12 BKZ 160 mg (SS) - up to Wk 73 BKZ 320 mg (SS) - up to Wk 73
    Number of subjects analysed
    60
    61
    58
    149
    150
    Units: percentage of participants
        number (not applicable)
    3.3
    0
    3.4
    3.4
    4.0
    No statistical analyses for this end point

    Secondary: Percentage of participants who withdrew due to an adverse event (AE) during the study

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    End point title
    		 Percentage of participants who withdrew due to an adverse event (AE) during the study
    End point description
    An AE is any untoward medical occurrence in a participant or trial subject that is administered a drug or biologic (medicinal product) or that is using a medical device. The event does not necessarily have a causal relationship with that treatment or usage. The results of this Secondary Outcome Measure were summarized from the adverse event pages of the Case Report Forms. The SS consisted of all randomized participants who received at least 1 dose of IMP.
    End point type
    Secondary
    End point timeframe
    From Screening until Safety Follow-Up Visit (up to Week 77)
    End point values
    		 Placebo (SS) - up to Wk 12 BKZ 16 mg (SS) - up to Wk 12 BKZ 64 mg (SS) - up to Wk 12 BKZ 160 mg (SS) - up to Wk 73 BKZ 320 mg (SS) - up to Wk 73
    Number of subjects analysed
    60
    61
    58
    149
    150
    Units: percentage of participants
        number (not applicable)
    1.7
    3.3
    1.7
    4.7
    6.7
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Treatment-emergent adverse events (TEAEs) were collected from Baseline until the Safety Follow-Up Visit (up to Week 73)
    Adverse event reporting additional description
    At Week 12, placebo, BKZ 16 mg and BKZ 64 mg subjects were re-randomized to either BKZ 160 mg or BKZ 320 mg. Subjects randomized to BKZ 160 mg group or BKZ 320 mg at Baseline were not re-randomized at Week 12 and remained on their original treatment. The Safety Set is based on actual treatment, other populations are based on planned treatment.
    Assessment type
    		 Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    		 MedDRA
    Dictionary version
    19.0
    Reporting groups
    Reporting group title
    BKZ 16 mg (SS) - up to Wk 12
    Reporting group description
    		 This arm consisted of all participants who received bimekizumab (BKZ) 16 milligrams (mg) every 4 weeks (Q4W) at any time in the study (up to Week 12). Participants formed the SS.

    Reporting group title
    Placebo (SS) - up to Wk 12
    Reporting group description
    		 This arm consisted of all participants who received placebo at any time in the study (up to Week 12). Participants formed the Safety Set (SS).

    Reporting group title
    BKZ 320 mg (SS) - up to Wk 73
    Reporting group description
    		 This arm consisted of all participants who received bimekizumab (BKZ) 320 mg every 4 weeks (Q4W) at any time in the study (up to Week 73). Participants formed the SS.

    Reporting group title
    BKZ 160 mg (SS) - up to Wk 73
    Reporting group description
    		 This arm consisted of all participants who received bimekizumab (BKZ) 160 mg every 4 weeks (Q4W) at any time in the study (up to Week 73). Participants formed the SS.

    Reporting group title
    BKZ 64 mg (SS) - up to Wk 12
    Reporting group description
    		 This arm consisted of all participants who received bimekizumab (BKZ) 64 mg every 4 weeks (Q4W) at any time in the study (up to Week 12). Participants formed the SS.

    Serious adverse events
    		 BKZ 16 mg (SS) - up to Wk 12 Placebo (SS) - up to Wk 12 BKZ 320 mg (SS) - up to Wk 73 BKZ 160 mg (SS) - up to Wk 73 BKZ 64 mg (SS) - up to Wk 12
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 61 (0.00%)
    2 / 60 (3.33%)
    6 / 150 (4.00%)
    5 / 149 (3.36%)
    2 / 58 (3.45%)
         number of deaths (all causes)
    0
    0
    0
    1
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Colon adenoma
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    0 / 149 (0.00%)
    1 / 58 (1.72%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Foot fracture
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    0 / 149 (0.00%)
    1 / 58 (1.72%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Laceration
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    1 / 150 (0.67%)
    0 / 149 (0.00%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    1 / 149 (0.67%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    1 / 149 (0.67%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    1 / 150 (0.67%)
    0 / 149 (0.00%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    0 / 149 (0.00%)
    1 / 58 (1.72%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Inner ear disorder
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    1 / 150 (0.67%)
    0 / 149 (0.00%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Pancreatitis acute
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    1 / 150 (0.67%)
    0 / 149 (0.00%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Crohn's disease
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    1 / 150 (0.67%)
    0 / 149 (0.00%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Haemorrhoids
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    0 / 149 (0.00%)
    1 / 58 (1.72%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Intestinal haemorrhage
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    0 / 149 (0.00%)
    1 / 58 (1.72%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Abdominal pain
         subjects affected / exposed
    0 / 61 (0.00%)
    1 / 60 (1.67%)
    0 / 150 (0.00%)
    0 / 149 (0.00%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pneumonia aspiration
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    1 / 149 (0.67%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Osteoarthritis
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    1 / 150 (0.67%)
    0 / 149 (0.00%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Bursitis infective
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    1 / 150 (0.67%)
    0 / 149 (0.00%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Abscess limb
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    1 / 149 (0.67%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pilonidal cyst
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    1 / 149 (0.67%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    1 / 149 (0.67%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    0 / 150 (0.00%)
    1 / 149 (0.67%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Postoperative wound infection
         subjects affected / exposed
    0 / 61 (0.00%)
    1 / 60 (1.67%)
    0 / 150 (0.00%)
    0 / 149 (0.00%)
    0 / 58 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    		 BKZ 16 mg (SS) - up to Wk 12 Placebo (SS) - up to Wk 12 BKZ 320 mg (SS) - up to Wk 73 BKZ 160 mg (SS) - up to Wk 73 BKZ 64 mg (SS) - up to Wk 12
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    2 / 61 (3.28%)
    2 / 60 (3.33%)
    56 / 150 (37.33%)
    42 / 149 (28.19%)
    4 / 58 (6.90%)
    Infections and infestations
    Oral candidiasis
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    8 / 150 (5.33%)
    8 / 149 (5.37%)
    0 / 58 (0.00%)
         occurrences all number
    0
    0
    11
    10
    0
    Oral fungal infection
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    6 / 150 (4.00%)
    8 / 149 (5.37%)
    0 / 58 (0.00%)
         occurrences all number
    0
    0
    8
    8
    0
    Bronchitis
         subjects affected / exposed
    0 / 61 (0.00%)
    1 / 60 (1.67%)
    12 / 150 (8.00%)
    4 / 149 (2.68%)
    2 / 58 (3.45%)
         occurrences all number
    0
    1
    12
    4
    2
    Nasopharyngitis
         subjects affected / exposed
    2 / 61 (3.28%)
    0 / 60 (0.00%)
    19 / 150 (12.67%)
    13 / 149 (8.72%)
    1 / 58 (1.72%)
         occurrences all number
    2
    0
    22
    19
    1
    Pharyngitis
         subjects affected / exposed
    0 / 61 (0.00%)
    0 / 60 (0.00%)
    7 / 150 (4.67%)
    11 / 149 (7.38%)
    0 / 58 (0.00%)
         occurrences all number
    0
    0
    7
    11
    0
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 61 (0.00%)
    1 / 60 (1.67%)
    11 / 150 (7.33%)
    5 / 149 (3.36%)
    1 / 58 (1.72%)
         occurrences all number
    0
    1
    11
    7
    1

    More information

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    Substantial protocol amendments (globally)
    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    09 Mar 2018
    The purpose of this substantial protocol amendment was the following: - To update the study contact details for the sponsor study physician and clinical trial biostatistician. - To revise the withdrawal criteria section to provide instructions for the management of participants with newly diagnosed inflammatory bowel disease (IBD) or with IBD flares during the study. - Amend the time window between doses during the Double-Blind Period of the study. - To revise and clarify the SAE criteria for pregnancy for consistency. - Amend the table for identification/exclusion of alternative etiology to include alanine aminotransferase (ALT) and aspartate aminotransferase (AST).

    Interruptions (globally)
    Were there any global interruptions to the trial? No

    Limitations and caveats
    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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