Drug survival of Adalimumab and Infliximab in Hidradenitis Suppurativa Patients: A Daily Practice Cohort Study

BACKGROUND Biologics are often required for treatment of hidradenitis suppurativa (HS). However, data on the drug survival of biologics in daily practice are currently lacking. OBJECTIVES To assess the drug survival of anti-TNF biologics in a daily practice cohort of HS patients and to identify predictors for drug survival. METHODS A retrospective multicenter study was performed in two academic dermatology centers in The Netherlands. Adult HS patients using biologics between 2008 and 2020 were included. Drug survival was analyzed using Kaplan Meier survival curves, predictors of survival using univariate Cox regression analysis. RESULTS Overall drug survival of adalimumab (n=104) at 12 and 24 months was 56.3% and 30.5%, mostly due to ineffectiveness. Older age (p=0.01) and longer disease duration (p=0.01) were associated with longer survival time. For infliximab (n=44), the overall drug survival was 58.3% and 48.6% at 12 and 24 months and was predominantly determined by infectiveness and side-effects. Surgery during treatment (p<0.01) was associated with a longer survival time. LIMITATIONS This study was limited by its retrospective design. CONCLUSION Survival rates are comparable for adalimumab and infliximab at 12 months and are mainly determined by ineffectiveness. Age, disease duration (adalimumab) and surgery (infliximab) are predictors for longer survival.