The efficacy and tolerability of tetracyclines and clindamycin plus rifampicin for the treatment of hidradenitis suppurativa: Results of a prospective European cohort study

Straalen, Kelsey R. van; Tzellos, Thrasyvoulos; Guillem, Phillipe; Benhadou, Farida; Cuenca‐Barrales, Carlos; Daxhelet, Mathilde; Daoud, Mathieu; Efthymiou, Ourania; Giamarellos‐Bourboulis, Evangelos J.; Jemec, Gregor B. E.; Katoulis, Alexandros; Koenig, Anke; Lazaridou, Elizabeth; Marzano, Angelo Valerio; Matusiak, Łukasz; Molina-Leyva, Alejandro; Moltrasio, Chiara; Pinter, Andreas; Potenza, Concetta; Romaní, Jorge; Saunte, Ditte Marie Lindhardt; Skroza, Nevena; Stergianou, Dimitra; Szepietowski, Jacek C.; Trigoni, Anastasia; Vilarrasa, Eva; Zee, Hessel H. van der

doi:10.1016/j.jaad.2020.12.089

Cited by 59 publications

(69 citation statements)

References 34 publications

(86 reference statements)

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“…Commonly used systemic therapies include tetracyclines, dapsone, IV ertapenem and combination therapies of 1) clindamycin and rifampicin or 2) moxifloxacin, metronidazole and rifampicin. 211,212 In addition to the bacteriostatic or bactericidal properties, many antibiotics also have anti-inflammatory properties. Tetracycline antibiotics suppress immune cell chemotaxis and also inhibit matrix metalloproteinase (MMP) activity, 213 which likely contributes to their effectiveness as an HS therapy.…”

Section: The Impac T Of Antib I Oti C S On the S K In Microb I Omementioning

confidence: 99%

Yin and Yang: A disrupted skin microbiome and an aberrant host immune response in hidradenitis suppurativa

Schell

Schneider

Nelson

2021

Experimental Dermatology

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Hidradenitis suppurativa (HS) is a chronic multifaceted, potentially scarring, inflammatory skin disease affecting the pilosebaceous units (PSU) of the axilla, inframammary folds, groin and buttocks. Clinical features include painful inflammatory nodules, abscesses and draining sinus tracts that produce a purulent, foul-smelling discharge. The estimated prevalence of HS is 0.2-0.6% globally, but the prevalence varies by geographic location: 0.5-1.3% in Europe, 0.7-1.2% in the United States and 0.01%-2.2% in the Asia-Pacific region. 1,2 Common comorbidities and behaviours associated with HS include diabetes, pulmonary disease, metabolic syndrome, obesity, polycystic ovary syndrome, inflammatory bowel disease, smoking and mechanical stress on skin. 1,3-5 HS negatively impacts patients' quality of life and causes significant economic burden on patients and the healthcare system. [6][7][8][9][10] The pathogenesis of HS is not fully understood. However, evidence supports the hypothesis that hair follicle occlusion leads to follicle rupture and an aberrant immune response to follicular and bacterial debris, triggering a cycle of damage and chronic inflammation. 7,[11][12][13][14] Factors involved in HS pathogenesis include genetics, hormones, local environmental factors (eg sweating, skin friction), abnormal host responses to skin bacteria and impaired wound healing. [15][16][17][18] Approximately 30% of patients have a family history of HS, and of these, about 10% of these familial cases have an inactivating mutation in the γ-secretase enzyme complex. 19,20 These γ-secretase mutations are relatively uncommon in sporadic cases of HS (~6%). 21 γ-secretase activity in the skin

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Section: The Impac T Of Antib I Oti C S On the S K In Microb I Omementioning

confidence: 99%

Yin and Yang: A disrupted skin microbiome and an aberrant host immune response in hidradenitis suppurativa

Schell

Schneider

Nelson

2021

Experimental Dermatology

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“…The results showed no significant differences in efficacy between the two treatments, regardless of the disease severity. 65…”

Section: Treatmentmentioning

confidence: 99%

“…10 A recent multicenter prospective cohort study showed significant decrease in IHS4 from baseline and a 40% of HiSCR achievement after 12-week treatment with tetracycline. 65 Likewise, a retrospective study comparing the efficacy of lymecycline (300 mg daily) versus the combination therapy clindamycin and rifampicin (600 mg plus 600 mg daily) during 10 weeks in 52 patients (26 per group) observed a 57.7% and 53.8% HiSCR achievement, respectively. 66 Clindamycin and rifampicin used at a dose of 300 mg twice daily have been proven effective in HS in several observational studies 65,[67][68][69] and are considered a first-line and second-line treatment for HS.…”

Section: Topical Treatmentmentioning

confidence: 99%

“…The results showed no significant differences in efficacy between the two treatments, regardless of the disease severity. 65 The association of daily clindamycin (600-1800 mg, according to weight) and ofloxacin (200-400 mg) for a mean observation period of 4.3 months in 65 patients led to a 33.8% (22/65) of complete response and a 24.6% (16/65) of partial response. 72 The authors state that the overall response rates obtained (58.4) could be comparable with the ones achieved with association of rifampicin and clindamycin.…”

Section: Topical Treatmentmentioning

confidence: 99%

“…Clindamycin and rifampicin used at a dose of 300 mg twice daily have been proven effective in HS in several observational studies 65,67–69 and are considered a first-line and second-line treatment for HS. A systematic review of retrospective and prospective series reported response rates from 71% to 93% in 187 patients, strongly favoring their use.…”

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

New perspectives on the treatment of hidradenitis suppurativa

Amat-Samaranch

Agut-Busquet

Vilarrasa

et al. 2021

Therapeutic Advances in Chronic Disease

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by the presence of painful nodules, abscesses, chronically draining fistulas, and scarring in apocrine gland-bearing areas of the body. The exact pathogenesis of HS is not yet well understood, but there is a consensus in considering HS a multifactorial disease with a genetic predisposition, an inflammatory dysregulation, and an influence of environmental modifying factors. Therapeutic approach of HS is challenging due to the wide clinical manifestations of the disease and the complex pathogenesis. This review describes evidence for effectiveness of current and emerging HS therapies. Topical therapy, systemic treatments, biological agents, surgery, and light therapy have been used for HS with variable results. Adalimumab is the only US Food and Drug Administration (FDA) approved biologic agent for moderate-to-severe HS, but new therapeutic options are being studied, targeting different specific cytokines involved in HS pathogenesis. Comparing treatment outcomes between therapies is difficult due to the lack of randomized controlled trials. Treatment strategy should be selected in concordance to disease severity and requires combination of treatments in most cases.

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Systemic nonbiologic treatments for hidradenitis suppurativa

Greif

Gibson

Porter

2022

Dermatological Reviews

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Hidradenitis suppurativa (HS) is a severe and painful chronic dermatologic condition affecting hair follicles with a significant negative impact on patient quality of life.Effective treatment of HS has proven challenging and often involves multiple modalities. These include topical treatments, systemic antibiotics, retinoids, hormonal therapies, biologic and nonbiologic immunosuppressants, small molecule inhibitors, surgery, and photodynamic/radiation therapy. This review outlines the nonbiologic systemic therapies for HS and describes the latest research on these therapies. Therapies covered in this review include systemic antibiotics, retinoids, hormonal therapies, nonbiologic immunosuppressants, and small molecule inhibitors.

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The efficacy and tolerability of tetracyclines and clindamycin plus rifampicin for the treatment of hidradenitis suppurativa: Results of a prospective European cohort study

Abstract: The efficacy and tolerability of tetracyclines and clindamycin plus rifampicin for the treatment of hidradenitis suppurativa; results of a prospective European cohort study

Cited by 59 publications

References 34 publications

Yin and Yang: A disrupted skin microbiome and an aberrant host immune response in hidradenitis suppurativa

Yin and Yang: A disrupted skin microbiome and an aberrant host immune response in hidradenitis suppurativa

New perspectives on the treatment of hidradenitis suppurativa

Systemic nonbiologic treatments for hidradenitis suppurativa

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