The Anti-Inflammatory Drug Colchicine Lacks Efficacy in Hidradenitis Suppurativa

Zee, Hessel H. van der; Prens, Errol P.

doi:10.1159/000332846

Cited by 32 publications

(19 citation statements)

References 48 publications

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“…Six patients dropped out before the end of the study because of lack of efficacy. Of the two patients who completed the 4-month period, only one showed slight improvement [106].…”

Section: Colchicinementioning

confidence: 92%

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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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“…Six patients dropped out before the end of the study because of lack of efficacy. Of the two patients who completed the 4-month period, only one showed slight improvement [106].…”

Section: Colchicinementioning

confidence: 92%

“…The anti-inflammatory drug colchicine accumulates in neutrophils, inhibits neutrophil expression of cell adhesion molecules, and decreases neutrophil degranulation, chemotaxis, and phagocytosis [105,106]. In a small case series of eight HS patients, colchicine did not show any clinical improvement.…”

Section: Colchicinementioning

confidence: 96%

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Deckers

Prens

2015

Drugs

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“…88 One therapy with colchicine, an effective medication in other diseases with inflammasomes, such as familial mediterranean fever and gout, was evaluated in eight patients with HS, but it proved not to be beneficial. 89 …”

Section: Dermatological Diseases Associated With Inflammasomesmentioning

confidence: 99%

Inflammasomes and dermatology

Sá

Neto

2016

An. Bras. Dermatol.

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Inflammasomes are intracellular multiprotein complexes that comprise part of the innate immune response. Since their definition, inflammasome disorders have been linked to an increasing number of diseases. Autoinflammatory diseases refer to disorders in which local factors lead to the activation of innate immune cells, causing tissue damage when in the absence of autoantigens and autoantibodies. Skin symptoms include the main features of monogenic inflammasomopathies, such as Cryopyrin-Associated Periodic Syndromes (CAPS), Familial Mediterranean Fever (FMF), Schnitzler Syndrome, Hyper-IgD Syndrome (HIDS), PAPA Syndrome, and Deficiency of IL-1 Receptor Antagonist (DIRA). Concepts from other pathologies have also been reviewed in recent years, such as psoriasis, after the recognition of a combined contribution of innate and adaptive immunity in its pathogenesis. Inflammasomes are also involved in the response to various infections, malignancies, such as melanoma, autoimmune diseases, including vitiligo and lupus erythematosus, atopic and contact dermatitis, acne, hidradenitis suppurativa, among others. Inhibition of the inflammasome pathway may be a target for future therapies, as already occurs in the handling of CAPS, through the introduction of IL-1 inhibitors. This study presents a literature review focusing on the participation of inflammasomes in skin diseases.

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“…Immunomodulation through monoclonal antibody drugs have also shown variable efficacy. Infliximab has been shown to lack of response in 20% and relapse in 50% after 37 week treatment courses [19]. Two recent studies on adalimumab have shown variable clinical response of 17% to 100% demonstrating that higher powered studies are needed to elucidate the topic [20,21].…”

Section: Immunomodulatorsmentioning

confidence: 99%

Hidradenitis Suppurativa

Lim¹

2013

Anaplastology

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PsychologyHidradenitis causes profound quality of life issues. This is due to chronic pain, odor, drainage, and illness. The result is days of work lost, low self-confidence, impaired sexual health, and even depression in some patients. Most of the disability of HS stems from the soreness and pain of the lesions [9]. A study by Matusiak et al. revealed that of the 30 employed patients, 58.1% had reported absence from work caused by HS, and during the 2 year follow up period, 10% were let go due to the frequency of their absences [10].Of particular importance, it was demonstrated that patients with HS suffer more sexual dysfunction compared to age, gender, and BMI matched controls [1]. Interestingly, it was found that women report greater sexual distress than men with HS of similar severity [1]. This may indicate that female patients with hidradenitis should be screened more closely for sexual dysfunction [1].Additionally, a survey-based study by Von Der Werth and Jemec found that hidradenitis led to lower quality of life scores than other chronic skin conditions such as psoriasis and acne [9]. Depression is more prevalent in sufferers of HS as well, Vazquez et al. found that over 40% of patients with HS had a diagnosis of depression [1,11]. Thus, it would be prudent for physicians to have a lower threshold when considering referral for psychological evaluation. Overall, improvements in management of this disease would likely relieve many of these psychological sequelae. Associated FactorsAlthough the precise etiology of HS remains unclear, there are a number of associated factors that have been consistently described. Many of these pre-disposing factors have insufficient or inconclusive evidence to support them. Of the factors that are well-established associations, strong evidence to explain causation remains lacking.There is a well-recognized association between cigarette smoking and HS [1]. Cross-sectional analyses have demonstrated a strong epidemiologic correlation, with study populations reporting from 70% to as high as 90% of disease sufferers being documented smokers. Some studies have demonstrated remission of disease with smoking cessation, while others show decreased rates of recurrence of disease after surgical resection with concomitant smoking cessation post-operatively.The role of sex hormones has been extensively reported but a clear consensus has not been reached on this topic. Evidence of hormonal

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The Anti-Inflammatory Drug Colchicine Lacks Efficacy in Hidradenitis Suppurativa

Cited by 32 publications

References 48 publications

An Update on Medical Treatment Options for Hidradenitis Suppurativa

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Inflammasomes and dermatology

Hidradenitis Suppurativa

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