This site is intended for healthcare professionals
Hidradenitis suppurativa (HS) Learning Zone
Declaration of sponsorship Novartis Pharma AG

HS Treatment

Declaration of sponsorship Novartis Pharma AG
Read time: 75 mins
Last updated:25th May 2022
Published:16th Sep 2021

Discover how timely and efficacious treatment of hidradenitis suppurativa (HS) is needed to minimise the immense burden of the disease. Also learn about: 

  • The unmet needs for patients with hidradenitis suppurativa in our interview with Dr Joslyn Kirby
  • Treatment goals and treatment options available for hidradenitis suppurativa patients
  • The future of hidradenitis suppurativa treatment in our overview of clinical trials

Unmet needs in HS


Join Dr Joslyn Kirby to gain an overview of the unmet needs for patients with hidradenitis suppurativa.

The significant diagnostic delay of hidradenitis suppurativa, in addition to the unpredictability of the disease and response to treatment, has led to a number of unmet needs for patients1.

An understanding of these unmet needs is essential for creating multidisciplinary approaches to care, developing new treatments, guiding researching, and supporting patients1.

What are unmet needs in the life impact and comorbidities of hidradenitis suppurativa?

To determine the unmet needs of patients with hidradenitis suppurativa, the Global Survey Of Impact and Healthcare Needs (Global VOICE) project (N = 1,299) carried out the largest and most comprehensive multinational study of patient perspectives1.

In the study, a large proportion of hidradenitis suppurativa patients reported a moderate to extreme and domain-specific impact on their life caused by the disease1. Moreover, 10% of patients reported being unable to find employment and 15% considered themselves disabled and unable to work1.

A smaller, but more recent study on unmet needs in people with hidradenitis suppurativa reported that 47% of patients found the referral process ‘very difficult’ and although biologics improved symptoms in 63% of patients, time to receiving treatment was >2 years2.

Hidradenitis suppurativa can have a large impact on life, such as reduced enjoyment of activities, independence, self-esteem and body image as well as increased stigmatisation and isolation3–5

The need to appropriately assess the psychological burden and impact on quality of life of hidradenitis suppurativa is currently a notable unmet need that may be addressed through the development of a disease-specific quality of life instrument for measuring life impact (Table 1)1,2

Table 1: Unmet needs of patients with hidradenitis suppurativa and potential mechanisms to address them (Adapted1). POC, point-of-care; QoL, quality of life.

Domain Unmet need Potential mechanisms to address unmet needs
Life impact and comorbid conditions Life impact assessment • Disease-specific QoL instrument to measure life impact
Mental wellness • Address psychosocial impact of the disease through interdisciplinary care with mental health professionals
Diagnosis and disease awareness Disease awareness • Promote advocacy and interdisciplinary education with patient support groups and medical organisations
• Research and peer-reviewed publication
Delay in diagnosis • Develop POC diagnostics to help distinguish abscess and inflamed epidermal cysts by non-dermatologists
• Promote the role of the dermatologist in diagnosis and management
Quality and cost of care • Improve dermatology access to manage disease flares
Associated diseases • Identify associated conditions, their related mechanisms, and their modification with treatment
• Develop guidelines with recommendations for prevention and screening of associated conditions
• Establish interdisciplinary care teams to provide comprehensive care
Treatment and management Safe and effective treatment • Develop reliable and feasible tools to measure disease
• Develop relevant outcome measures to assess treatment efficacy
• Advance research to identify disease mechanism and potential therapeutic targets
• Develop medical treatments with improved efficacy and safety profiles
• Evaluate outcomes for procedural treatments
• Develop guidelines for pain management
Control of symptoms • Develop appropriate and effective strategies to address pain, drainage, odour, fatigue, and flare

Mental wellness

There is also an important unmet need to address the considerable psychosocial concerns associated with hidradenitis suppurativa1.

Mood disorders are likely due to the physical and psychosocial impact of the disease, resulting in a reduction in quality of life1

More than 30% of patients in the Global VOICE project reported depression or anxiety, with mood disorders in general representing the most common comorbidity. Notably, around 9% of patients reported suicidal ideation or a suicide attempt. In light of the known association between hidradenitis suppurativa and completed suicide, this high frequency represents a significant issue1.

These concerns may be addressed through coping and resilience strategies as well as interdisciplinary care with mental health professionals (Table 1)1.

Register for free access to this exclusive healthcare learning resource


Why sign up with Medthority?

Develop your knowledge with our disease and condition focused Learning Zones

Access content from credible sources, including expert-led commentary, videos, podcasts, and webinars as well as clinical trials, treatment information and guidelines 

Personalised dashboard providing updates and recommendations for content within your areas of interest

HS treatment goals


Explore the treatment goals of hidradenitis suppurativa with Dr Joslyn Kirby, including the reduction of symptoms and long-term control.

Currently, the treatment of hidradenitis suppurativa consists of several types of medication and surgical management based on the individual subjective impact and objective severity of the disease. The aim of treatment is to improve quality of life by limiting the incidence and duration of flares, reducing inflammation and suppuration, relieving pain, and preventing infection (Figure 1)7–9.

Reducing the symptoms of hidradenitis suppurativa

The aim of treatment is to prevent new lesions and reduce the extent and progression of the disease. Current guidelines recommend the use of medications, procedures, lifestyle changes, and complementary and alternative medicine10.

A wide range of medications can be used to reduce flares, manage pain, and improve quality of life, including8:

  • antibiotics (to prevent infections)
  • biologics (to target the pathophysiology and reduce inflammation)
  • corticosteroids (to reduce inflammation)
  • hormones (to reduce androgen effects on symptoms)
  • retinoids (to reduce inflammation and heal lesions)
  • topical and intralesional therapies (to aid healing and soften / shed scaly skin)

Lifestyles changes, such as reducing smoking and losing weight, can also help to reduce the symptoms of hidradenitis suppurativa10.

Typically, surgical interventions cure hidradenitis suppurativa lesions locally, through the removal of irreversibly damaged skin. However, remaining dermal sinus tracts or tunnels may lead to recurrence. Alternatively, systemic treatment with anti-inflammatory antibiotics may result in less surgery by11,12:

  • lowering disease activity (such as inflammation and pain)
  • reducing the size of the affected area

It is therefore recommended that, at Hurley stage II and above, anti-inflammatory treatment should be considered an induction therapy before surgery11,12.

T2 HS_Fig1.png

Figure 1. Treatment goals for hidradenitis suppurativa3,7,8,13

Relieving pain in hidradenitis suppurativa

Pain is a significant factor of hidradenitis suppurativa that reduces the quality of life of patients14. Guidelines recommend an individualised treatment plan provided by a variety of healthcare professionals, such as7,8:

  • dermatologists
  • pain specialists
  • psychologists
Register for free access to this exclusive healthcare learning resource


Why sign up with Medthority?

Develop your knowledge with our disease and condition focused Learning Zones

Access content from credible sources, including expert-led commentary, videos, podcasts, and webinars as well as clinical trials, treatment information and guidelines 

Personalised dashboard providing updates and recommendations for content within your areas of interest

Treatment options for HS


Find out the treatment options that are currently available to reduce symptoms, relieve pain, and prevent infection with Dr Joslyn Kirby.

Hidradenitis suppurativa is lifelong, recurring, and difficult to manage. Early recognition and treatment are essential for preventing progression of the disease. Treatment should be tailored to the patient, with medications in early stages followed by surgery in more severe cases6,7.

Currently, data is limited for novel treatments of hidradenitis suppurativa. However, as the understanding of HS increases, exciting new research is driving the development of the future treatment landscape. Here we provide an overview of some of the data for current and novel HS treatments.

What lifestyle changes can help to manage hidradenitis suppurativa?

Outside of medication and surgery, a variety of lifestyle changes have been shown to positively impact the disease activity or severity of hidradenitis suppurativa22–25.

Smoking cessation

It is widely known that active smokers have a poorer long-term prognosis than non-smokers or former smokers22,23. In a previous study, it was shown that 49% of former smokers and non-smokers reported remission compared with 29% of active smokers, after a median follow-up of 22 years23.

Weight loss

In patients with hidradenitis suppurativa, a positive correlation has been seen between body mass index and disease severity24. A retrospective study (N = 383) showed that two years after receiving bariatric surgery, 49% of patients reported no symptoms, 20% reported less activity, 20% reported no change, and 11% experienced an increase in disease activity25.

Are there topical treatments for hidradenitis suppurativa?

Two topical treatments are available for mild inflammatory hidradenitis suppurativa, resorcinol cream and clindamycin lotion26.

Topical clindamycin is often the first-line therapy for mild to moderate HS with evidence from multiple clinical trials supporting its safety and efficacy. A small double-blind randomised control trial (N = 30) of patients with Hurley stage I and II hidradenitis suppurativa showed a reduction in nodules, abscesses, and pustules following three months of daily topical clindamycin27. Further studies have also shown that clindamycin can reduce pain after 16 weeks28.

However, there is growing evidence that these antibiotic-based treatments are contributing to antibiotic resistance 29,30. In a cross-sectional analysis of 239 patients using topical clindamycin, a large proportion developed antibiotic resistant strains of Staphylococcus aureus when compared to patients using no antibiotics, prompting the authors to recommend that a more targeted approach for long-term HS treatment was necessary, such as resorcinol cream29.

Resorcinol cream is utilised for its keratolytic effect and mild antiseptic properties26. In an open study (N = 32) of patients with Hurley stage I and II disease applying resorcinol (15%) twice daily for 30 days, 19% achieved clinical resolution of a treated boil after 7 days, and 84% after 30 days31. In a larger study investigating patient satisfaction with 15% resorcinol treatment, 84.8% of patients were highly satisfied with treatment based on effectiveness and side-effects32.

A 2022 study comparing 15% resorcinol with 1% clindamycin at 12 weeks of treatment reported that patients receiving resorcinol saw significant improvements in all endpoint analyses when compared to clindamycin33. Topical resorcinol is therefore a strong contender for improved HS treatment, and an alternative to clindamycin to prevent antibiotic resistance.

Register for free access to this exclusive healthcare learning resource


Why sign up with Medthority?

Develop your knowledge with our disease and condition focused Learning Zones

Access content from credible sources, including expert-led commentary, videos, podcasts, and webinars as well as clinical trials, treatment information and guidelines 

Personalised dashboard providing updates and recommendations for content within your areas of interest

Future treatments for moderate-to-severe HS

Get to know the novel treatments currently being investigated that leverage the evolving understanding of hidradenitis suppurativa pathophysiology with Dr Joslyn Kirby.

Unravelling the pathogenic pathways involved in the development of hidradenitis suppurativa is paving the way for novel therapeutic targets. Currently, there are various small-molecule drugs and biologics under investigation with the aim of targeting new therapeutic targets in moderate-to-severe hidradenitis suppurativa55.

What treatments are currently being investigated for hidradenitis suppurativa?

A variety of novel treatment targets are currently being investigated for hidradenitis suppurativa (Figure 1) that may give rise to a better control of the disease. These include targets such as, tumour necrosis factor (TNF)-α, various interleukins, leukotriene B4, and the Janus kinase (JAK) pathway55.

T2 HS_Fig2.png

Figure 3. Proposed key cells and mediators in the evolution of hidradenitis suppurativa and associated pathogenesis-based target therapies under investigation (Adapted55). IL, interleukin; JAK, janus kinase; LTB4, leukotriene B4; TNF-α, tumour necrosis factor-α. * Adalimumab is FDA and EMA approved for moderate-to-severe hidradenitis suppurativa in adults and adolescents from 12 years of age; with an active disease and prior failure to systemic treatment stipulation for the EMA label46,47.

Are there any novel TNFα inhibitors being investigated for hidradenitis suppurativa?

Infliximab

One prospective, randomised, double blind, placebo-controlled, crossover study of infliximab has been published (Table 4). In this study, significantly more patients from the infliximab group reached a 25–50% decrease in the hidradenitis suppurativa severity index (HSSI) than in the placebo group (P<0.001)56.

However, patients on the induction schedule of 5 mg/kg for eight weeks followed by a maintenance regimen every eight weeks have been seen to develop “wearing off” effects approximately four weeks following infusion. A 4-week interval may therefore be more effective57.

Etanercept

A small, placebo-controlled, randomised control trial (N = 20) compared etanercept 50 mg subcutaneously twice weekly to placebo for 12 weeks. However, despite double dosing, no difference was found in the Physician’s Global Assessment, Patient’s Global Assessment or Dermatology Life Quality Index (DLQI)58.

Register for free access to this exclusive healthcare learning resource


Why sign up with Medthority?

Develop your knowledge with our disease and condition focused Learning Zones

Access content from credible sources, including expert-led commentary, videos, podcasts, and webinars as well as clinical trials, treatment information and guidelines 

Personalised dashboard providing updates and recommendations for content within your areas of interest

References

  1. Garg A, Neuren E, Cha D, Kirby JS, Ingram JR, Jemec GBE, et al. Evaluating patients’ unmet needs in hidradenitis suppurativa: Results from the Global Survey Of Impact and Healthcare Needs (VOICE) Project. J Am Acad Dermatol. 2020;82(2):366–376.
  2. Shi V, Kirby J, Hsiao J, Nguyen E, Muscianisi E. Patient and Dermatologist Perspectives on Unmet Needs in Hidradenitis Suppurativa. Presented at the American Association of Dermatology Annual Meeting 2022, 26 March. Boston, Massachusetts. Poster ID: 32834 https://eposters.aad.org/abstracts/32834.
  3. Matusiak. Profound consequences of hidradenitis suppurativa: a review. Br J Dermatol. 2020;183(6):e171–e177.
  4. Thorlacius L, Cohen AD, Gislason GH, Jemec GBE, Egeberg A. Increased Suicide Risk in Patients with Hidradenitis Suppurativa. J Invest Dermatol. 2018;138(1):52–57.
  5. Kouris A, Platsidaki E, Christodoulou C, Efstathiou V, Dessinioti C, Tzanetakou V, et al. Quality of Life and Psychosocial Implications in Patients with Hidradenitis Suppurativa. Dermatology. 2017;232(6):687–691.
  6. Reddy S, Strunk A, Garg A. Comparative Overall Comorbidity Burden among Patients with Hidradenitis Suppurativa. JAMA Dermatology. 2019;155(7):797–802.
  7. Zouboulis CC, Desai N, Emtestam L, Hunger RE, Ioannides D, Juhász I, et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatology Venereol. 2015;29(4):619–644.
  8. Alikhan A, Sayed C, Alavi A, Alhusayen R, Brassard A, Burkhart C, et al. North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations: Part II: Topical, intralesional, and systemic medical management. J Am Acad Dermatol. 2019;81(1):91–101.
  9. Seyed Jafari SM, Hunger RE, Schlapbach C. Hidradenitis Suppurativa: Current Understanding of Pathogenic Mechanisms and Suggestion for Treatment Algorithm. Front Med. 2020;7:68.
  10. Margesson LJ, Danby FW. Hidradenitis suppurativa. Best Pract Res Clin Obstet Gynaecol. 2014;28(7):1013–1027.
  11. Van Rappard DC, Mekkes JR. Treatment of severe hidradenitis suppurativa with infliximab in combination with surgical interventions. Br J Dermatol. 2012;167(1):206–208.
  12. Falola RA, DeFazio M V., Anghel EL, Mitnick CDB, Attinger CE, Evans KK. What heals hidradenitis suppurativa: Surgery, immunosuppression, or both? Plast Reconstr Surg. 2016;138(3):219S-229S.
  13. Matusiak Ł, Szczęch J, Kaaz K, Lelonek E, Szepietowski JC. Clinical characteristics of pruritus and pain in patients with hidradenitis suppurativa. Acta Derm Venereol. 2018;98(2):191–194.
  14. Von Der Werth JM, Jemec GBE. Morbidity in patients with hidradenitis suppurativa. Br J Dermatol. 2001;144(4):809–813.
  15. Danby FW, Margesson LJ. Hidradenitis suppurativa. Dermatol Clin. 2010;28(4):779–793.
  16. Alikhan A, Lynch PJ, Eisen DB. Hidradenitis suppurativa: A comprehensive review. J Am Acad Dermatol. 2009;60(4):539–561.
  17. Gulliver W, Zouboulis CC, Prens E, Jemec GBE, Tzellos T. Evidence-based approach to the treatment of hidradenitis suppurativa/acne inversa, based on the European guidelines for hidradenitis suppurativa. Rev Endocr Metab Disord. 2016;17(3):343–351.
  18. Horváth B, Janse IC, Blok JL, Driessen RJB, Boer J, Mekkes JR, et al. Hurley staging refined: A proposal by the dutch hidradenitis suppurativa expert group. Acta Derm Venereol. 2017;97(3):412–413.
  19. Ingram JR. Hidradenitis suppurativa outcome measures and treatment goals. Br J Dermatol. 2014;171(6):1293–1294.
  20. Ingram JR, Hadjieconomou S, Piguet V. Development of core outcome sets in hidradenitis suppurativa: systematic review of outcome measure instruments to inform the process. Br J Dermatol. 2016;175(2):263–272.
  21. Kimball AB, Sobell JM, Zouboulis CC, Gu Y, Williams DA, Sundaram M, et al. HiSCR (Hidradenitis Suppurativa Clinical Response): a novel clinical endpoint to evaluate therapeutic outcomes in patients with hidradenitis suppurativa from the placebo-controlled portion of a phase 2 adalimumab study. J Eur Acad Dermatology Venereol. 2016;30(6):989–994.
  22. Sartorius K, Emtestam L, Jemec GBE, Lapins J. Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesity. Br J Dermatol. 2009;161(4):831–839.
  23. Kromann CB, Deckers IE, Esmann S, Boer J, Prens EP, Jemec GBE. Risk factors, clinical course and long-term prognosis in hidradenitis suppurativa: A cross-sectional study. Br J Dermatol. 2014;171(4):819–824.
  24. Schrader AMR, Deckers IE, Van Der Zee HH, Boer J, Prens EP. Hidradenitis suppurativa: A retrospective study of 846 Dutch patients to identify factors associated with disease severity. J Am Acad Dermatol. 2014;71(3):460–467.
  25. Kromann CB, Ibler KS, Kristiansen VB, Jemec GBE. The influence of body weight on the prevalence and severity of hidradenitis suppurativa. Acta Derm Venereol. 2014;94(5):553–557.
  26. van Straalen KR, Schneider-Burrus S, Prens EP. Current and future treatment of hidradenitis suppurativa. Br J Dermatol. 2020;183(6):e178–e187.
  27. Clemmensen OJ. Topical Treatment of Hidradenitis Suppurativa with Clindamycin. Int J Dermatol. 1983;22(5):325–328.
  28. Jemec GBE, Wendelboe P. Topical clindamycin versus systemic tetracycline in the treatment of hidradenitis suppurativa. J Am Acad Dermatol. 1998;39(6):971–974.
  29. Hessam S, Sand M, Georgas D, Anders A, Bechara FG. Microbial Profile and Antimicrobial Susceptibility of Bacteria Found in Inflammatory Hidradenitis Suppurativa Lesions. Skin Pharmacol Physiol. 2016;29(3):161–167.
  30. Bettoli V, Manfredini M, Massoli L, Carillo C, Barozzi A, Amendolagine G, et al. Rates of antibiotic resistance/sensitivity in bacterial cultures of hidradenitis suppurativa patients. J Eur Acad Dermatol Venereol. 2019;33(5):930–936.
  31. Pascual JC, Encabo B, Ruiz de Apodaca RF, Romero D, Selva J, Jemec GB. Topical 15% resorcinol for hidradenitis suppurativa: An uncontrolled prospective trial with clinical and ultrasonographic follow-up. J Am Acad Dermatol. 2017;77(6):1175–1178.
  32. Docampo-Simón A, Beltrá-Picó I, Sánchez-Pujol MJ, Fuster-Ruiz-De-Apodaca R, Selva-Otaolaurruchi J, Betlloch I, et al. Topical 15% Resorcinol Is Associated with High Treatment Satisfaction in Patients with Mild to Moderate Hidradenitis Suppurativa. Dermatology. 2022;238(1):82–85.
  33. Molinelli E, Brisigotti V, Simonetti O, Sapigni C, D’Agostino GM, Rizzetto G, et al. Efficacy and safety of topical resorcinol 15% versus topical clindamycin 1% in the management of mild-to-moderate hidradenitis suppurativa: A retrospective study. Dermatol Ther. 2022;e15439.
  34. Sapadin AN, Fleischmajer R. Tetracyclines: Nonantibiotic properties and their clinical implications. J Am Acad Dermatol. 2006;54(2):258–265.
  35. Van Der Zee HH, Boer J, Prens EP, Jemec GBE. The effect of combined treatment with oral clindamycin and oral rifampicin in patients with hidradenitis suppurativa. Dermatology. 2009;219(2):143–147.
  36. Mendonça CO, Griffiths CEM. Clindamycin and rifampicin combination therapy for hidradenitis suppurativa. Br J Dermatol. 2006;154(5):977–978.
  37. Gener G, Canoui-Poitrine F, Revuz JE, Faye O, Poli F, Gabison G, et al. Combination therapy with clindamycin and rifampicin for hidradenitis suppurativa: A series of 116 consecutive patients. Dermatology. 2009;219(2):148–154.
  38. Bettoli V, Zauli S, Borghi A, Toni G, Minghetti S, Ricci M, et al. Oral clindamycin and rifampicin in the treatment of hidradenitis suppurativa-acne inversa: A prospective study on 23 patients. J Eur Acad Dermatology Venereol. 2014;28(1):125–126.
  39. Pasquale TR, Tan JS. Nonantimicrobial effects of antibacterial agents. Clin Infect Dis. 2005;40(1):127–135.
  40. Van Vlem B, Vanholder R, De Paepe P, Vogelaers D, Ringoir S. Immunomodulating effects of antibiotics: Literature review. Infection. 1996;24(4):275–291.
  41. Tsankov N, Angelova I. Rifampin in dermatology. Clin Dermatol. 2003;21(1):50–55.
  42. Ziglam HM, Daniels I, Finch RG. Immunomodulating activity of rifampicin. J Chemother. 2004;16(4):357–361.
  43. Hoyer P, Momin F, Ellison E, Ahatov R, Weisert E, Wilson J. An Updated Reference for Empiric Antibiotic Therapy in Hidradenitis Suppurativa. Presented at the American Association of Dermatology Annual Meeting 2022, 26 March. Boston, Massachusetts. Poster ID: 35305 https://eposters.aad.org/abstracts/35305.
  44. Lee EY, Alhusayen R, Lansang P, Shear N, Yeung J. Qu’est-ce que l’hidradénite suppurée? Can Fam Physician. 2017;63(2):114.
  45. Lee EY, Alhusayen R, Lansang P, Shear N, Yeung J. Qu’est-ce que l’hidradénite suppurée? Can Fam Physician. 2017;63(2):114.
  46. U.S. Food and Drug Administration (FDA). HUMIRA Highlights of prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/125057s410lbl.pdf. Accessed 29 July 2021.
  47. European Medicines Agency (EMA). Humira Summary of Product Characteristics (SmPC). 2021. https://www.ema.europa.eu/en/documents/product-information/humira-epar-product-information_en.pdf. Accessed 28 July 2021.
  48. Kimball AB, Kerdel F, Adams D, Mrowietz U, Gelfand JM, Gniadecki R, et al. Adalimumab for the treatment of moderate to severe hidradenitis suppurativa: A parallel randomized trial. Ann Intern Med. 2012;157(12):846–855.
  49. Kimball AB, Okun MM, Williams DA, Gottlieb AB, Papp KA, Zouboulis CC, et al. Two Phase 3 Trials of Adalimumab for Hidradenitis Suppurativa. N Engl J Med. 2016;375(5):422–434.
  50. Saad S, Haley C, Hatfield J, Shah R, Parekh P. Efficacy of 80 mg/week dose of adalimumab (Humira) in treatment of Hidradenitis Suppurativa. Presented at the American Association of Dermatology Annual Meeting 2022, 26 March. Boston, Massachusetts. Poster ID: 33431 https://eposters.aad.org/abstracts/33431.
  51. Aarts P, Dudink K, Vossen ARJV, van Straalen KR, Ardon CB, Prens EP, et al. Clinical Implementation of Biologics and Small Molecules in the Treatment of Hidradenitis Suppurativa. Drugs. 2021;81(12):1397–1410.
  52. Vu T, Soong L, Keeling C. Prospective Study of Surgical Deroofing in the Management of Hidradenitis Suppurativa. Presented at the American Association of Dermatology Annual Meeting 2022, 26 March. Boston, Massachusetts. Poster ID: 34222.
  53. Ritz JP, Runkel N, Haier J, Buhr HJ. Extent of surgery and recurrence rate of hidradenitis suppurativa. Int J Colorectal Dis. 1998;13(4):164–168.
  54. Van Der Zee HH, Prens EP, Boer J. Deroofing: A tissue-saving surgical technique for the treatment of mild to moderate hidradenitis suppurativa lesions. J Am Acad Dermatol. 2010;63(3):475–480.
  55. Zouboulis CC, Benhadou F, Byrd AS, Chandran NS, Giamarellos-Bourboulis EJ, Fabbrocini G, et al. What causes hidradenitis suppurativa ?—15 years after. Exp Dermatol. 2020;29(12):1154–1170.
  56. Grant A, Gonzalez T, Montgomery MO, Cardenas V, Kerdel FA. Infliximab therapy for patients with moderate to severe hidradenitis suppurativa: A randomized, double-blind, placebo-controlled crossover trial. J Am Acad Dermatol. 2010;62(2):205–217.
  57. Moriarty B, Jiyad Z, Creamer D. Four-weekly infliximab in the treatment of severe hidradenitis suppurativa. Br J Dermatol. 2014;170(4):986–987.
  58. Adams DR, Yankura JA, Fogelberg AC, Anderson BE. Treatment of hidradenitis suppurativa with etanercept injection. Arch Dermatol. 2010;146(5):501–504.
  59. Sabat R, Jemec GBE, Matusiak Ł, Kimball AB, Prens E, Wolk K. Hidradenitis suppurativa. Nat Rev Dis Prim. 2020;6(1). doi:10.1038/s41572-020-0149-1.
  60. Van Der Zee HH, De Ruiter L, Van Den Broecke DG, Dik WA, Laman JD, Prens EP. Elevated levels of tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-10 in hidradenitis suppurativa skin: A rationale for targeting TNF-α and IL-1β. Br J Dermatol. 2011;164(6):1292–1298.
  61. Schlapbach C, Hänni T, Yawalkar N, Hunger RE. Expression of the IL-23/Th17 pathway in lesions of hidradenitis suppurativa. J Am Acad Dermatol. 2011;65(4):790–798.
  62. Kelly G, Hughes R, McGarry T, Van Den Born M, Adamzik K, Fitzgerald R, et al. Dysregulated cytokine expression in lesional and nonlesional skin in hidradenitis suppurativa. Br J Dermatol. 2015;173(6):1431–1439.
  63. Tzanetakou V, Kanni T, Giatrakou S, Katoulis A, Papadavid E, Netea MG, et al. Safety and efficacy of anakinra in severe hidradenitis suppurativa a randomized clinical trial. JAMA Dermatology. 2016;152(1):52–59.
  64. Novartis. Novartis R&D day spotlights attractive growth profile, underpinned by strong in-market brands, 20 potential high value pipeline assets, and technology plat- forms. 2021. https://www.novartis.com/node/83456/printable/.
  65. Rosales Santillan M, Morss PC, Porter ML, Kimball AB. Biologic therapies for the treatment of hidradenitis suppurativa. Expert Opin Biol Ther. 2020;20(6):621–633.
  66. Yoshida Y, Oyama N, Iino S, Shimizu C, Hasegawa M. Long-standing refractory hidradenitis suppurativa responded to a brodalumab monotherapy in a patient with psoriasis: A possible involvement of Th17 across the spectrum of both diseases. J Dermatol. 2021;48(6):916–920.
  67. Arenbergerova M, Arenberger P, Marques E, Gkalpakiotis S. Successful treatment of recalcitrant gluteal hidradenitis suppurativa with brodalumab after anti-TNF failure. Int J Dermatol. 2020;59(6):733–735.
  68. Frew JW, Navrazhina K, Grand D, Sullivan-Whalen M, Gilleaudeau P, Garcet S, et al. The effect of subcutaneous brodalumab on clinical disease activity in hidradenitis suppurativa: An open-label cohort study. J Am Acad Dermatol. 2020;83(5):1341–1348.
  69. A Study to Test the Efficacy and Safety of Bimekizumab in Study Participants With Moderate to Severe Hidradenitis Suppurativa. Case Medical Research. 2020. doi:10.31525/ct1-nct04242498.
  70. Glatt S, Jemec GBE, Forman S, Sayed C, Schmieder G, Weisman J, et al. Efficacy and Safety of Bimekizumab in Moderate to Severe Hidradenitis Suppurativa. JAMA Dermatology. 2021. doi:10.1001/jamadermatol.2021.2905.
  71. Blok JL, Li K, Brodmerkel C, Horvátovich P, Jonkman MF, Horváth B. Ustekinumab in hidradenitis suppurativa: Clinical results and a search for potential biomarkers in serum. Br J Dermatol. 2016;174(4):839–846.
  72. Kanni T, Zenker O, Habel M, Riedemann N, Giamarellos-Bourboulis EJ. Complement activation in hidradenitis suppurativa: a new pathway of pathogenesis? Br J Dermatol. 2018;179(2):413–419.
  73. ClinicalTrials.gov. NCT03275870 - Hydroxychloroquine for the Treatment of Hidradenitis Suppurativa. https://clinicaltrials.gov/ct2/show/NCT03275870. Accessed 29 July 2021.
  74. Vossen ARJV, van Doorn MBA, van der Zee HH, Prens EP. Apremilast for moderate hidradenitis suppurativa: Results of a randomized controlled trial. J Am Acad Dermatol. 2019;80(1):80–88.
  75. Zouboulis CC, Frew JW, Giamarellos-Bourboulis EJ, Jemec GBE, del Marmol V, Marzano A V., et al. Target molecules for future hidradenitis suppurativa treatment. Exp Dermatol. 2021;30(S1):8–17.
  76. Giamarellos-Bourboulis EJ, Argyropoulou M, Kanni T, Spyridopoulos T, Otto I, Zenker O, et al. Clinical efficacy of complement C5a inhibition by IFX-1 in hidradenitis suppurativa: an open-label single-arm trial in patients not eligible for adalimumab. Br J Dermatol. 2020;183(1):176–178.
Register for free access to this exclusive healthcare learning resource


Why sign up with Medthority?

Develop your knowledge with our disease and condition focused Learning Zones

Access content from credible sources, including expert-led commentary, videos, podcasts, and webinars as well as clinical trials, treatment information and guidelines 

Personalised dashboard providing updates and recommendations for content within your areas of interest

Welcome: