Treatment of Hidradenitis Suppurativa with Tumour Necrosis Factor-alpha Inhibitors

Haslund, Poul; Lee, Robert A.; Jemec, Gregor B. E.

doi:10.2340/00015555-0747

Cited by 95 publications

(100 citation statements)

References 57 publications

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“…According to the current lines of evidence, adalimumab and infliximab, 2 different monoclonal antibodies against TNF-α, are effective in the treatment of moderate to severe HS (Hurley II-III) as well as in improving the quality of patient life, with adalimumab being more tolerable [97,98,99]. There are different rates of response to adalimumab reported in case series and in a current, prospective controlled study.…”

Section: Treatmentmentioning

confidence: 99%

Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review

Scuderi

Monfrecola

Dessy

et al. 2017

Skin Appendage Disord

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease presenting with painful nodules, abscesses, sinus tracts, and scarring primarily affecting apocrine gland-rich intertriginous areas. HS prevalence ranges from 0.05 to 1%. The central pathogenic event in HS is believed to be the occlusion of the upper part of the folliculopilosebaceous unit, leading to the rupture of the sebofollicular canal with the consequent development of perifollicular lymphohistiocytic inflammation. The HS treatment choices are influenced by disease severity and its individual subjective impact, involving both medical and surgical interventions. However, given the chronic nature of HS, its destructive impact on social, working, and daily life of patients, its management is often frustrating for both the patient and physician. Hence, prompt and effective management strategies are urgently needed and a multidisciplinary approach is advocated. Therefore, in this article, we highlighted the main features of HS (clinical aspects, epidemiology, pathogenesis, diagnostic criteria, classifications, comorbidities, and treatments), so that awareness of this disease might be heightened in primary care physicians and surgeons, who may be the first health care providers to see patients with this disease owing to its characteristic clinical presentation (inflammatory nodules, abscesses, sinus tract, etc.).

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Section: Treatmentmentioning

confidence: 99%

Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review

Scuderi

Monfrecola

Dessy

et al. 2017

Skin Appendage Disord

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“…In the explorative nature of this case series, it is however permissible and relevant to draw comparisons by analogy as such comparisons form the background for planning proper randomized controlled trials. Looking at the response rate, it seems that the effect of dapsone is not dissimilar to that of biological agents, such as tumour necrosis factor α inhibitors, which in the recent years have produced favourable outcomes with approximately 40% long-term improvement of HS patients [13,23,24,25]. When it comes to other systemic antibiotic treatments, tetracyclines are often used as mainstay systemic treatment.…”

Section: Discussionmentioning

confidence: 99%

Dapsone Therapy for Hidradenitis Suppurativa: A Series of 24 Patients

et al. 2011

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Background: Hidradenitis suppurativa (HS) is an inflammatory skin disease with a chronic intermittent course. HS is difficult to treat, and the evidence for the effect of most treatments consists of smaller open studies. The use of dapsone in the treatment of HS is based on a few published cases successfully treated. Objective: To evaluate the potential of dapsone treatment for HS in an open case series. Methods: An exploratory and retrospective review of case notes from HS patients treated with dapsone was performed. Patients were included irrespective of treatment outcome. Prior to the treatment the level of glucose-6-phosphate dehydrogenase in the blood was tested for all patients. Results: A total of 24 HS patients were included and treated with dapsone. Improvement was seen in 9 out of 24 (38%) treated patients, whereas 15 out of 24 (62%) did not experience any improvement. None of the 4 cases with severe disease experienced improvement. Side effects leading to discontinuation of the treatment occurred in 2 of 24 patients (8%). Recurrence of disease at the cessation of treatment was described as rapid. Limitations: The study is limited by lacking a control group. Conclusion: Therapy with dapsone for patients with HS is possible, particularly in milder cases. The effect may be due to either antibacterial or anti-inflammatory effects of the drug, or both. Rapid recurrence after stopping treatment however suggests that anti-inflammatory effects may predominate. The effect appears to be smaller than that reported with combination therapy using clindamycin and rifampicin. To clarify the true effect of dapsone future randomized controlled trials are necessary.

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“…Biological agents have offered beneficial therapeutic options for the treatment of several dermatologic diseases, such as psoriasis and pemphigus, among others. The success of TNF blockers such as infliximab in managing HS 8,9 in patients without HIV 1,10-12 offers a new therapeutic option and supports an underlying immunologic basis for the disease. Infliximab, a monoclonal chimeric anti-TNF antibody, was successfully used in other immune-based diseases in the setting of HIV-1 infection, such as Reiter syndrome, 2 HIV-associated psoriasis and psoriasis arthritis, 3 and HIV-associated Crohn diseases.…”

Section: Commentmentioning

confidence: 99%