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Smoking, age, care type may be factors with hidradenitis suppurativa treatment

The likelihood of receiving or escalating treatment for hidradenitis suppurativa was associated with clinician type, tobacco smoking and age, according to study results published in JAMA Dermatology.

Researchers conducted a retrospective cohort study of 427 patients (74% female; mean age at enrollment, 39.4 years) with hidradenitis suppurativa (HS) and at least five monitoring periods of 3 months’ duration. Patients were from Boston University Medical Center and six affiliated community health centers in Boston.

There was an average monitoring time of 4.2 patient-years.

“The frequency of patients with HS with no treatment decreased over the monitoring period, while the frequency for receipt of treatment increased,” the researchers wrote.

The strongest predictor of receiving treatment for HS (OR = 6.7; 95% CI, 5.2-8.6) and an association of increased odds of escalating treatments (OR = 3; 95% CI, 2.4-3.7) was care by a dermatologist.

Treatment escalation over time was associated with tobacco smoking (OR = 1.4; 95% CI, 1.1-1.7); however, there was no association with obesity and treatment or escalation.

Patients aged 18 to 39 years had an increased likelihood of receiving (OR = 1.4; 95% CI, 1.2-1.8) or escalating treatment (OR = 1.2; 95% CI, 1-1.4). No association was observed between male sex and treatment escalation.

“During this study period, the frequency of patients with HS receiving no treatment decreased, while the frequency of their receiving any treatment increased,” the researchers wrote. “This may suggest that the natural course of disease involves increasing severity over time, prompting patients to seek treatment.

“We have observed course of disease in HS to be progressive. We have identified clinical factors that patients and clinicians may consider in developing partnered short- and long-term treatment strategies. We have also identified factors, namely obesity and male sex, which do not seem to additionally influence treatment of HS.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.