Short-Term Effectiveness, Safety, and Potential Predictors of Response of Secukinumab in Patients with Severe Hidradenitis Suppurativa Refractory to Biologic Therapy: A Multicenter Observational Retrospective Study

Abstract

Introduction Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Biologic drugs have a key role in the long-term anti-inflammatory treatment of moderate to severe patients due to their immunomodulatory properties. The aim of this study is to evaluate the effectiveness and safety of secukinumab in patients with moderate to severe HS after 16 weeks of treatment, and to explore potential predictors of clinical response to the drug. Methods Multicenter observational retrospective study. Patients treated with secukinumab 300 mg every 2 or 4 weeks who had completed at least 16 weeks of follow-up from nine hospitals based in southern Spain (Andalusia) were included in this study. Treatment effectiveness was assessed using the Hidradenitis Suppurativa Clinical Response (HiSCR). Information about adverse events was collected, the therapeutic burden of the patients was calculated as the summation of systemic medical treatments and surgical interventions (excluding incision and drainage) experienced until the start of secukinumab treatment. Results Forty-seven patients with severe HS were included for analysis. At week 16, 48.9% (23/47) of patients achieved HiSCR. Adverse events were present in 6.4% (3/47) of the patients. The multivariate analysis showed that female sex and, to a lesser extent, lower body mass index (BMI) and a lower therapeutic burden were potentially associated with a higher probability of HiSCR achievement. Conclusions Favorable short-term effectiveness and safety of secukinumab in the treatment of severe HS patients were observed. Female sex, lower BMI and a lower therapeutic burden may be associated with a higher probability of achieving HiSCR.

Brodalumab for moderate–severe hidradenitis suppurativa: An open‐label multicentric cohort study in real clinical practice

“…Recently, female sex, lower BMI and lower therapeutic burden have been described as potential response markers in patients under secukinumab and moderate to severe HS (7). In our study, we did not observe differences between patients who achieved HiSCR and those who did not in those variables or in any other.…”

“…Mean therapeutic burden, defined as the summatory of all systemic treatments used and surgical interventions was 6.56 (SD 4.30). 7 All patients had failed to previous treatment with adalimumab for a median pretreatment time of 131 weeks and 68.75% of patients had received another biological drug (secukinumab was prescribed in 10 patients and risankizumab in one patient). Concomitant treatment was prescribed in 50% of patients at the start of the treatment.…”

“…All patients presented Hurley stage II (3; 18.8%) or III (13; 81.3%). Mean therapeutic burden, defined as the summatory of all systemic treatments used and surgical interventions was 6.56 (SD 4.30) 7 …”

Brodalumab for moderate-severe hidradenitis suppurativa: an open-label multicentric cohort study in real clinical practice

“…All patients presented Hurley stage II (3; 18.8%) or III (13; 81.3%). Mean therapeutic burden, de ned as the summatory of all systemic treatments used and surgical interventions was 6.56 (SD 4.30) (7).…”

Emerging Treatments and the Clinical Trial Landscape for Hidradenitis Suppurativa Part I: Topical and Systemic Medical Therapies

“…[ 78 ] Across six studies (including retrospective series, retrospective cohort studies, and open-label trials), 83 out of 150 (55.3%) achieved HiSCR at weeks 16 or 24 [ 79 – 84 ]. All utilized psoriasis dosing except in two studies, one where 12 out of 47 patients were dosed bimonthly and one where 13 out of 23 patients had dose escalation to every 2 or 3 weeks depending on clinical response [ 82 , 84 ]. Multiple case reports/small case series have also been published regarding secukinumab use in HS [ 85 – 96 ].…”