42824 Demographic and Therapeutic Trends in Clinical Trials for Hidradenitis Suppurativa
Kathleen MulliganKatie A. O’ConnellAreebah AhmadLori KimMadeline ColemanAlexandra da SilvaRobert P. Dellavalle
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Hidradenitis Suppurativa
Blinding
Adalimumab is the only biologic therapy approved for the treatment of patients with hidradenitis suppurativa, a chronic and disabling skin condition. To date, there are no studies in the literature about the effectiveness of adalimumab biosimilar SB5 in hidradenitis suppurativa. The aim of this study was to evaluate its efficacy and safety. A retrospective observational study was performed in hidradenitis suppurativa adalimumab naive patients and in patients who were switched from the adalimumab originator. Eleven patients were included in the study. Our results support adalimumab SB5 as an effective and well tolerated drug, with a good interchangeability with its originator also for the treatment of hidradenitis suppurativa.
Hidradenitis Suppurativa
Section (typography)
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A sporadic association between hidradenitis suppurativa and other diseases is reported in the literature, but few authors have described the association with Crohn's disease.Adalimumab is a fully human monoclonal antibody targeted at tumor necrosis factor alpha approved for the treatment of Crohn's disease and, recently, for active moderate to severe hidradenitis suppurativa in adult patients that do not respond adequately to systemic conventional treatment.We report an unusual case of a paradoxical effect of adalimumab in the onset of hidradenitis suppurativa in a 40-year-old woman during the treatment of Crohn's disease.
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Ultrasonography has proven useful for diagnosis and treatment monitoring in patients with hidradenitis suppurativa. The aim of this study was to assess the clinical response to adalimumab using ultrasound findings. This prospective study collected data on demographic features, disease severity, and hidradenitis suppurativa findings from patients with hidradenitis suppurativa treated with adalimumab. Generalized estimating equations investigated relationships between disease severity measures and clinical/demographic variables. The study included a total of 41 patients with hidradenitis suppurativa who were treated with adalimumab for a mean period of 50.8 ± 32.2 weeks; range 6-108 weeks). Clinical improvement was observed during adalimumab therapy, with a progressively greater number of patients achieving HiSCR50 response (36.4% at week 52). Disease duration was identified as the most relevant clinical variable affecting disease severity and treatment response. Treatment response was also influenced by treatment duration, with a 4% greater likelihood of achieving HiSCR50 response at each time-point. At the ultrasound examination, subcutaneous involvement of hidradenitis suppurativa lesions was identified as a predictive negative factor for clinical response to adalimumab (HiSCR50 achievement).
Hidradenitis Suppurativa
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Hidradenitis suppurativa is a chronic inflammatory skin disease featuring inflammatory nodules, fistulas and discharge of secretions in the intertriginous regions. Without therapy the disease is chronic and progressive. The most effective treatment is the radical wide excision of the affected areas. Systemic antibiotics, immunosuppressants, oral retinoids or antiandrogens have limited beneficial effects. TNF-alpha antagonists may represent a new therapeutic approach for patients suffering from severe hidradenitis suppurativa offering promising positive influence on the disease outcome. In contrast to infliximab and etanercept, there are only few reports describing the use of adalimumab in severe hidradenitis suppurativa. Here we report a case of a patient with severe recalcitrant hidradenitis suppurativa successfully treated with adalimumab.
Hidradenitis Suppurativa
Intertriginous
Antiandrogens
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New results from a phase-3 study demonstrating the effect of Humira (adalimumab, AbbVie) in treating moderate-to-severe hidradenitis suppurativa (HS) may lead to worldwide regulatory filings for expanded use of the drug.
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Adalimumab is the only approved biologic treatment for moderate‐to‐severe hidradenitis suppurativa, nonetheless, long‐term data from real‐life setting are still limited. The objective of this observational multicenter study was to evaluate the effectiveness, safety, and drug survival of adalimumab in patients with hidradenitis suppurativa included in the BIOREP registry. A total of 299 patients who initiated adalimumab therapy for hidradenitis suppurativa from 2011 to November 2021 were included. The Dermatology‐Life‐Quality‐Index (DLQI), pain scale, the number of abscesses, inflammatory nodules and draining tunnels, and International Hidradenitis Suppurativa Severity Score System (IHS4) were recorded in the 0 th , 3 rd , and 6 th months; then every 6 months during the ongoing adalimumab treatment. Studied patients underwent treatment for up to 48 months, with the average duration of treatment lasting 2.3 years. The mean age of the patients was 44.9 years, 79% were smokers or ex‐smokers, 54.8% were obese, and 26.4% were overweight, the mean BMI was 30.8. The mean time from diagnosis to initiation adalimumab therapy was 9.1 years. The number of patients with severe IHS4 dropped from the initial 249 (83.3%) to 65 (30.1%) after 12 months and this trend was maintained up to the 48 th month. A decreasing number of inflammatory lesions were rapid and sustained and correlated to the improvement of patients’ quality of life, the mean DLQI score dropped from 17.6 to 8.5 after 3 months and to 5, 7 after 48 months. No unexpected risk signals were observed. Our long‐term study demonstrates the effectiveness and safety of adalimumab in a real‐life setting.
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Psoriasis and hidradenitis suppurativa are inflammatory dermatoses that have been associated with arthritis, metabolic syndrome, obesity, and smoking. They share common pathogenic mechanisms such as elevated levels of several proinflammatory cytokines including tumor necrosis factor (TNF), interleukin-17A, and impaired Notch pathway. Thus, treatments for both diseases are sometimes overlapping. Biological therapy such as adalimumab is effective for patients with hidradenitis suppurativa and psoriasis. Adalimumab is a monoclonal antibody that binds to TNF and inhibits the cytokine interaction with the TNF receptors, thus inhibiting the inflammatory cascade. Currently, data are lacking on the treatment for co-occurrence of psoriasis and hidradenitis suppurativa. This case series describes three patients with a diagnosis of concomitant psoriasis and hidradenitis suppurativa. In these cases, after 12 weeks of treatment with adalimumab 40 mg every other week, the average Psoriasis Area Severity Index score reduced from 21.4 to 2.9 for psoriasis, Hidradenitis Suppurativa-Physician's Global Assessment from 3.3 to 0.7, and pain Visual Analog Scale for hidradenitis suppurativa from 4.6 to 2. The results suggest that adalimumab is a treatment of choice for patients with concomitant hidradenitis suppurativa and psoriasis.
Hidradenitis Suppurativa
Concomitant
Proinflammatory cytokine
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Aim: To discuss the new beneficial effect of adalimumab in the management of hidradenitis suppurativa(HS).Case: We report a 25-year-old arabic female with a 14-year history with long-standing poorly controlled active hidradenitis suppurativa who was successfully treated with adalimumab.Discussion: Hidradenitis suppurativa is a skin disorder characterized by the formation of multiple cysts, abscesses and sinus tracts in apocrine gland-bearing areas. The aetiology and pathogenesis of HS are unknown. Current medical and surgical therapies are only minimally effective at treating the disease. The biologic agent Adalimumab is a new promising agent for the treatment of HS.Conclusion: The biologic agent adalimumab is an effective treatment for HS
Hidradenitis Suppurativa
Apocrine
Etiology
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Hidradenitis Suppurativa
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Hidradenitis suppurativa (HS) is a chronic, inflammatory disease characterized by recurring abscesses, nodules, and fistulas predominantly in the area of the groin and axillae. The association between HS and Crohn's disease (CD) has already been documented. We report on a case of a patient with CD associated HS, refractory to multiple local and systemic agents.A complete resolution of both diseases was finally achieved after treatment with adalimumab. Our case report supports the co-occurrence of both diseases and suggests that adalimumab approved for CD might also be a safe and effective therapeutic option in the treatment of HS.
Hidradenitis Suppurativa
Refractory (planetary science)
Intertriginous
Groin
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