Severe Hidradenitis Suppurativa Treated With Adalimumab

Moul, Danielle K.; Korman, Neil J.

doi:10.1001/archderm.142.9.1110

Cited by 70 publications

(65 citation statements)

References 12 publications

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“…A group of 6 patients with recalcitrant severe hidradenitis suppurativa was treated with a subcutaneous dose of 25 mg of etanercept twice a week; after a 24-week treatment, a 61% decrease in the disease’s subjective seriousness index and a 64% improvement of the dermatology life quality index were found [12]. There have also been reported isolated cases of severe hidradenitis suppurativa with good response to adalimumab with 1 subcutaneous dose of 40 mg every 2 weeks [13]. …”

Section: Discussionmentioning

confidence: 99%

Infliximab for the Treatment of Hidradenitis Suppurativa

Fernández–Vozmediano

Armario-Hita²

2007

Dermatology

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Introduction: Hidradenitis suppurativa is a chronic inflammatory disease characterized by significant morbidity. Current medical therapies are usually only minimally effective. Objective: To assess the efficacy and safety of infliximab monotherapy for the treatment of severe extensive refractory forms of hidradenitis suppurativa. Design: A retrospective study in a group of 6 patients who received treatment with infliximab for hidradenitis suppurativa, in the Dermatology Department of the University Hospital of Puerto Real in the last year. The dose was 5–10 mg/kg at weeks 0, 2 and 6, followed by a maintenance dose every 4 weeks. Subjective and objective efficacy was assessed before and after each treatment session. Results: All patients experienced improvement in subjective symptoms after the initial dose. A decrease in exudation, the size and number of lesions and less development of fistulous tracts were observed. The patients were followed up during 6 months. Treatment was generally well tolerated and there was only one mild reaction to the infusion in the form of headache. No patient required treatment discontinuation due to adverse effects. Conclusions: Infliximab was shown to be an effective therapeutic alternative for severe extensive forms of hidradenitis suppurativa when it is used as monotherapy.

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Section: Discussionmentioning

confidence: 99%

Infliximab for the Treatment of Hidradenitis Suppurativa

Fernández–Vozmediano

Armario-Hita²

2007

Dermatology

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“…The first reports of the use of adalimumab in HS patients dates from 2006 [73,74]. Initially it showed efficacy in an African American male with concomitant seronegative arthritis [73] and later in a Caucasian male with concomitant inflammatory bowel disease [74].…”

Section: Adalimumabmentioning

confidence: 99%

“…Initially it showed efficacy in an African American male with concomitant seronegative arthritis [73] and later in a Caucasian male with concomitant inflammatory bowel disease [74]. Over the years multiple studies followed, reporting different clinical outcomes.…”

Section: Adalimumabmentioning

confidence: 99%

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Deckers

Prens

2015

Drugs

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent inflammatory nodules mostly located in the armpits and groin. Over the years multiple treatments for HS have been proposed; however, to date a cure is still lacking. In this update we provide an overview of most drug treatments reported on for HS, where possible with their mode of action and side effects. In mild cases, clindamycin lotion or resorcinol cream have proven effective. Tetracyclines are a first-line systemic option in more widespread or severe cases, followed by the combination of clindamycin and rifampicin. However, the recurrence rate is high after discontinuation of clindamycin plus rifampicin combination therapy. Long-term treatment with retinoids, especially acitretin is feasible, although teratogenicity has to be taken into account in females of reproductive age. Multiple antiinflammatory drugs have been suggested for HS, such as dapsone, fumarates or cyclosporine. However, their effectiveness in HS is based on small case series with varying results. If most common treatments have failed, biologics (e.g., infliximab or adalimumab) are the next step. Although not addressed in this review, surgical interventions are often needed to achieve remission. Key PointsHidradenitis suppurativa (HS) is a chronic inflammatory skin disease without a cure.Antibiotics (topical or oral) are often the first treatment option for HS.In cases of more extensive or therapy-resistant HS, biologicals (e.g., infliximab or adalimumab) are a good therapeutic option.

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“…Its addition to therapy with infl iximab was concluded by authors as a prevention of neutralizing antibodies formation and thus prevention of infl iximab effi cacy reduction. Case reports, series of patients and trials studying the effect of etanercept and adalimumab on hidradenitis suppurativa were published (15,16,17,18). The results were comparable with infl iximab -fast improvement of the disease, but often the recurrency occurs soon, even though cases of long-lasting remission without the need of continuous treatment were described.…”

Section: Discussionmentioning

confidence: 97%

Hidradenitis suppurativa treated with combination of infliximab and dapsone

Kozub¹,

Šimaljaková²

2012

BLL

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Hidradenitis suppurativa (HS) is chronic infl ammatory disease characterized by recurrent painful nodules, which leads to forming an abscess and sinus tracts, together with pustulation and hypertrophic scarring in the areas of apocrine sweat glands. Systemic and local antibiotic therapy, together with corticoid therapy, sulphonates, retinoids and surgical treatment with incisions and drainage belongs to actual treatment possibilities. Biological therapy represents the absolute peak in the treatment last years, mostly TNFα-inhibitors. Even though their very good short term effect is described, long term keeping up the good long effect of the treatment is not achieved with satisfaction. This is the reason to reach for traditional therapeutic possibilities combined with biological treatment in cases of torpid and resistive disease. In the following article a case report of a patient with hidradenitis suppurativa treated subsequently with combination of TNFα-inhibitors and dapson (Fig. 6, Ref. 19 Hidradenitis suppurativa (HS) is chronic infl ammatory disease characterized by recurrent painful nodules, which leads to forming an abscess and sinus tracts, together with pustulation and hypertrophic scarring in the areas of apocrine sweat glands. It is spread evenly between both genders. Obesity and smoking belong to risk factors. Hormonal factors are also described, which is supported by the fact, that the disease can be mitigated in gravidity. Various infections can worsen the existing manifestations. In clinical fi ndings painful nodules and fi stulas draining pus are seen. Predilection areas of the disease are the areas with apocrine glands (axillar and inguinal areas, perigenital and perianal area, submammar space), ectopic nodules can be located anywhere on the body. Sanation is accompanied with forming of hypertrophic scars, which can lead to dermogenous contractures. Systemic and local antibiotic therapy, together with corticoid therapy, sulfones, retinoids and surgical treatment with incisions and drainage belongs to actual treatment possibilities. Complete restoration is in the present possible only by removing the skin with apocrinne sweat glands in the full thickness, which can result in cosmetic disturbing features, dermogennous contractures and with predisposed individuals the new focus can appear in other part rich in apocrine sweat glands. Biologics, mainly TNFα-inhibitors, are even more often fi nding their place in the treatment of other diseases, where an important role is played by tumor necrosis factor alpha (TNFα). Hidradenitis suppurativa is one of these diseases. Case report53-years old female with two years history of hidradenitis suppurativa was admited at the Clinic of Dermatovenerology in Bratislava in March 2009. Painful nodules and many fi stulas in the medial part of thighs (Figs 1 and 2), left gluteal and submammar area were dominating the clinical fi ndings, ectopic focuses were found on the front side of the body. Axillar, perigenital and inguinal areas were not affected. Pati...

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Severe Hidradenitis Suppurativa Treated With Adalimumab

Cited by 70 publications

References 12 publications

Infliximab for the Treatment of Hidradenitis Suppurativa

Infliximab for the Treatment of Hidradenitis Suppurativa

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Hidradenitis suppurativa treated with combination of infliximab and dapsone

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