Clinical response rate and flares of hidradenitis suppurativa in the treatment with adalimumab

Abstract

Background. Hidradenitis suppurativa/acne inversa (HS) is a chronic, inflammatory, skin disease. adalimumab is the sole approved drug for the treatment of HS, but it only partially controls the symptoms. Aim. To evaluate the incidence of flares during 108 weeks of therapy and the clinical response to adalimumab. Methods. In total, 20 patients with moderate-severe HS treated with adalimumab were included to evaluate the number of flares, mean time interval between flares, lesion count number of patients who reached the Hidradenitis Suppurativa Clinical Response (HiSCR) of ≥ 50% reduction in inflammatory lesion count, and the International Hidradenitis Suppurativa Severity Score System (IHS4), pain visual analogue scale (VAS) and Dermatology Life Quality Index (DLQI). Results. In total, 90% of patients reported at least 1 flare, and in total 48 flares were counted for the whole group; mean time between flares was 26.9 AE 16.4 weeks. Duration between flares was 30.5 AE 16.3 and 12.5 AE 5.7, respectively, in responders and nonresponders. A progressive decline in flares was observed with treatment, while a gradual increase in the number of patients achieving HiSCR was attained during the observational period. Lesion count, IHS4, pain VAS and DLQI decreased throughout the study. In detail, adalimumab showed a higher efficacy on nodules and abscesses than on draining tunnels. The study was limited by its retrospective nature and small number of patients. Conclusion. Adalimumab is an effective and safe treatment for patients with HS despite the high number of flares.

Clinical and demographic features of hidradenitis suppurativa: a multicentre study of 1221 patients with an analysis of risk factors associated with disease severity

“…Biologic agents were mostly prescribed for patients with Hurley stage III (31.7%). Adalimumab and infliximab are effective in the treatment of moderate‐to‐severe HS 22,23 . Consistent with current evidence, adalimumab was the most commonly used biologic therapy in our study.…”

Clinical selection criteria in new clinical trials of hidradenitis suppurativa: External validity and implications on the daily clinical practice

“…Our results show high response rates to adalimumab in agreement with previous research on adalimumab real‐life use 35,36 , Table 4. Other studies showed lower adalimumab effectiveness 37,38 . These differences might be explained by different sociodemographic and clinical characteristics and different outcome measures.…”

Clinical and Power‐Doppler ultrasound features related with persistence of fistulous tracts under treatment with adalimumab in hidradenitis suppurativa: 4 years of follow‐up

“…1 It is known from literature that fistulas are poorly responsive to the currently available medical treatments. 6,[9][10][11][12][13][14] At the same time, these lesions play a central role in the "window of opportunity" acting as a sort of watershed between medical and surgical approach. 6 Therefore, the analysis of their features related to their clinicalsonographic response may indicate when the medical therapy alone might be still effective.…”

“…It is known from literature that fistulas are poorly responsive to the currently available medical treatments 6,9‐14 . At the same time, these lesions play a central role in the “window of opportunity” acting as a sort of watershed between medical and surgical approach 6 .…”