Biologic therapies achieve high response in treatment of hidradenitis suppurativa

Biologic therapies have been proven to significantly change treatment ability and improve the condition of patients with hidradenitis suppurativa, according to a presentation at the Interdisciplinary Autoimmune Summit.

“Hidradenitis suppurativa is a chronic, recurrent inflammatory disease of the skin that generally has an insidious onset. ... The more important area or the harder to treat area would be the genital and the groin involvement. This area can be very challenging to treat and also very challenging in terms of patients’ overall quality of life,” Mital Patel-Cohen, MD, director of complex medical dermatology at Summit Medical Group in New Jersey, said. “There are many biologics that have been studied or are being studied in this particular condition. We have good basic science data to support that both the perilesional and lesional skin of patients with HS have higher levels of interleukin-1-beta, higher levels of TNF-alpha ... higher levels of IL-12, IL-23 and IL-17, and these are all cytokines that we have antagonists for, so this really opens up our ability to treat patients with HS.”

Particularly, FDA-approved biologic therapy adalimumab achieved high HS clinical response rates at week 12 in two phase 3 trials: 41.8% of patients in the PIONEER 1 trial and 58.9% of patients in the PIONEER 2 trial. Increased response rates in PIONEER 2 solidified the use of multimodal treatment to achieve better results.

Anti-TNF medication infliximab is another biologic therapy that carries firsthand favorable results, Patel-Cohen said. An infliximab study showed placing an emphasis on higher dosing and higher frequency of dosing will allow for more optimal results in the management of patients with HS.

“Treating HS can sometimes be discouraging because we feel like we’re not clearing patients the way we clear them with psoriasis,” Patel-Cohen said. “It’s important that these patients, although they have active lesions, their quality of life is significantly improved, their pain is significantly improved, and although we’re not perfect, we’re definitely getting there.”