Targeted treatments for hidradenitis suppurativa: a review of the current literature and ongoing clinical trials

Abstract

Currently, adalimumab is the only FDA-approved biologic available for the treatment of HS. However, results from trials of other biologic agents targeting downstream mediators are promising. Large-scale, randomized, placebo-controlled trials in patients with skin of color, as well as weight-based dosing trials, are needed.

Alterations in innate immunity and epithelial cell differentiation are the molecular pillars of hidradenitis suppurativa

“…Inflammation plays an important role in the pathogenesis of HS. In LS, cytokines and chemokines, such as TNFα, IL1, IL6, IL10, IL12, IL17, IL23, interferon (IFN)γ, phosphodiesterase‐4, complement 5α, uteroglobulin, chemokine (C‐X‐C motif) ligand (CXCL)6, CXCL9, CXCL11, CX3CL1, CC‐chemokine ligand (CCL)2, CCL18, TLR2, soluble IL2 receptor are upregulated, as described in proteome studies . Especially IL23 has been shown to induce IL17‐producing T helper cells (Th17), which infiltrate the dermis in HS lesions .…”

T helper 17 cell/regulatory T-cell imbalance in hidradenitis suppurativa/acne inversa: the link to hair follicle dissection, obesity, smoking and autoimmune comorbidities

“…It has recently been reported that HS exhibits a clinical response to seculinumab . Current therapeutic efforts focus on attenuating IL‐17 signalling in HS …”

“…Targeted immune therapy has recently been introduced for the management of HS. [122][123][124][125][126][127][128][129][130][131][132][133]…”

“…At present, there is a clinical focus on biological drugs in the treatment of HS. 133,193 Six agents, namely adalimumab, anakinra, etanercept, infliximab, ustekinumab and secukinumab, have been explored in the setting of HS treatment. 125 Among anti-TNF-a drugs, adalimumab and infliximab seem to obtain satisfactory results in HS.…”

Development of hidradenitis suppurativa in a patient treated with ustekinumab for her psoriasis: A potential paradoxical reaction?

“…promising results about the effectiveness of ustekinumab in the treatment of HS (Blok et al, 2016;Eisen, 2016;Maarouf, Clark, Lee, & Shi, 2018). Although, paradoxical reactions to adalimumab have been reported (Delobeau et al, 2016;Martina, Campanati, Giuliodori, & Offidani, 2017), there are no reports of HS while on treatment with ustekinumab.…”