Novel treatment paradigm bests standard of care in hidradenitis suppurativa

Key takeaways:

• International Hidradenitis Suppurativa Severity Score System improved a mean 9.3 points with a novel treatment paradigm at 12 months.
• Standard care yielded a reduction of 5.7 points at the same time point.

A novel treatment paradigm was associated with improved disease severity and patient satisfaction compared with standard of care in a cohort of patients with hidradenitis suppurativa, according to a study.

“Hidradenitis suppurativa is an inflammatory disease of the inverse skin regions that occurs particularly in young women and affects approximately 1% of the population,” Michael Schultheis, MD, of the department of dermatology at the University Medical Center, Johannes Gutenberg University, in Mainz, Germany, and colleagues wrote.

The researchers further wrote that outpatient care is “often inadequate” and insufficient to prevent disease progression.

In the EsmAiL trial, 553 patients with HS were assessed to determine whether using an innovative care concept can decrease disease activity and burden along with patient satisfaction parameters.

The prospective, randomized controlled trial was conducted at multiple centers. Eligible participants had at least three inflammatory lesions and a moderate impact of the disease on quality of life.

According to study protocols, 279 patients were treated according to a trial-specific, multimodal paradigm, whereas 274 patients were randomly assigned to remain in standard care. The absolute change in International Hidradenitis Suppurativa Severity Score System (IHS4) served as the primary outcome measure.

Results at 12 months were available for 377 patients overall, including 203 patients in the multimodal intervention group and 174 patients treated with standard care.

A mean improvement of 9.3 points in the IHS4 was observed in the intervention group. Conversely, a decrease of 5.7 points in IHS4 was observed in the standard care group (P = .003).

Significantly higher decreases in pain, DLQI and Hospital Anxiety and Depression Scale were also reported in the intervention group compared with the standard care group (P < .001).

Moreover, patients in the intervention group experienced higher patient satisfaction than those in the standard care group (P < .001).

“The establishment of standardized treatment algorithms in so-called ‘acne inversa centres’ in the ambulatory setting has a substantial, positive impact on the course of the disease and significantly improves patient satisfaction,” the researchers concluded.