Vol 8, No 2 (2022)
Review paper
Published online: 2022-04-04
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Biologic treatment for hidradenitis suppurativa — review of current literature

Miłosz Lewandowski1, Zuzanna Świerczewska1, Wioletta Barańska-Rybak1
Forum Dermatologicum 2022;8(2):69-75.


Hidradenitis suppurativa (HS) is a chronic, debilitating, recurring inflammatory skin condition defined by the presence of severe, persistent, painful nodules, abscesses, and fistulas in the skin folds of the axilla, groin, gluteal, and perianal regions. Hidradenitis suppurativa’s pathophysiology is still not completely known however, it is presently thought to be an immune-mediated inflammatory condition. The selection of the proper therapy is highly crucial in these patients due to the severe decline in their quality of life and the delayed beginning of treatment. Even though hidradenitis suppurativa offers a variety of therapeutic choices, no universally effective therapy has been discovered. All of the recommendations underline the importance of a multidisciplinary approach to the condition. Biologic therapy is recommended by guidelines as a therapy in moderate to severe HS. Currently, adalimumab is the only biologic drug registered by Food and Drug Administration in acne inversa treatment. Despite this fact, recommendations or clinical trials described the other biologic drugs like infliximab, anakinra, or ustekinumab to be also potentially effective and safe in hidradenitis suppurativa treatment. The aim of this article is to review the literature on the biological treatment used in the treatment of acne inversa.

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  1. Sabat R, Jemec G, Matusiak Ł, et al. Hidradenitis suppurativa. Nat Rev Dis Primers. 2020; 6(1): 18.
  2. Nguyen TV, Damiani G, Orenstein L, et al. Hidradenitis suppurativa: an update on epidemiology, phenotypes, diagnosis, pathogenesis, comorbidities and quality of life. J Eur Acad Dermatol Venereol. 2020; 35(1): 50–61.
  3. Theut Riis P, Pedersen OB, Sigsgaard V, et al. Prevalence of patients with self-reported hidradenitis suppurativa in a cohort of Danish blood donors: a cross-sectional study. Br J Dermatol. 2019; 180(4): 774–781.
  4. Delany E, Gormley G, Hughes R, et al. A cross-sectional epidemiological study of hidradenitis suppurativa in an Irish population (SHIP). J Eur Acad Dermatol Venereol. 2018; 32(3): 467–473.
  5. Calao M, Wilson JL, Spelman L, et al. Hidradenitis Suppurativa (HS) prevalence, demographics and management pathways in Australia: A population-based cross-sectional study. PLoS One. 2018; 13(7): e0200683.
  6. Ingram JR, Jenkins-Jones S, Knipe DW, et al. Population-based Clinical Practice Research Datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa. Br J Dermatol. 2018; 178(4): 917–924.
  7. Deckers IE, van der Zee HH, Boer J, et al. Correlation of early-onset hidradenitis suppurativa with stronger genetic susceptibility and more widespread involvement. J Am Acad Dermatol. 2015; 72(3): 485–488.
  8. Saunte DM, Boer J, Stratigos A, et al. Diagnostic delay in hidradenitis suppurativa is a global problem. British Journal of Dermatology. 2015; 173(6): 1546–1549.
  9. Tzellos T, Zouboulis CC. Review of Comorbidities of Hidradenitis Suppurativa: Implications for Daily Clinical Practice. Dermatol Ther (Heidelb). 2020; 10(1): 63–71.
  10. Zouboulis CC, Desai N, Emtestam L, et al. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. J Eur Acad Dermatol Venereol. 2015; 29(4): 619–644.
  11. Traczewski P, Rudnicka L. Adalimumab in dermatology. Br J Clin Pharmacol. 2008; 66(5): 618–625.
  12. Kyriakou A, Trigoni A, Galanis N, et al. Efficacy of adalimumab in moderate to severe hidradenitis suppurativa: Real life data. Dermatol Reports. 2018; 10(2): 7859.
  13. Kimball AB, Okun MM, Williams DA. Two Phase 3 Trials of Adalimumab for Hidradenitis Suppurativa. N Engl J Med. 2016; 375(5): 422–434.
  14. Zouboulis CC, Okun MM, Prens EP, et al. Long-term adalimumab efficacy in patients with moderate-to-severe hidradenitis suppurativa/acne inversa: 3-year results of a phase 3 open-label extension study. J Am Acad Dermatol. 2019; 80(1): 60–69.e2.
  15. Deckers IE, Prens EP. An Update on Medical Treatment Options for Hidradenitis Suppurativa. Drugs. 2016; 76(2): 215–229.
  16. Grant A, Gonzalez T, Montgomery MO, et al. 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.
  17. Mekkes JR, Bos JD. Long-term efficacy of a single course of infliximab in hidradenitis suppurativa. Br J Dermatol. 2008; 158(2): 370–374.
  18. Scheinfeld N. A comprehensive review and evaluation of the side effects of the tumor necrosis factor alpha blockers etanercept, infliximab and adalimumab. J Dermatolog Treat. 2004; 15(5): 280–294.
  19. Holcomb ZE, Porter ML, Kimball AB. A safety review of biologic therapies for the management of hidradenitis suppurativa and unmet needs. Expert Opin Drug Saf. 2021; 20(10): 1147–1161.
  20. Tzanetakou V, Kanni T, Giatrakou S, et al. Safety and Efficacy of Anakinra in Severe Hidradenitis Suppurativa: A Randomized Clinical Trial. JAMA Dermatol. 2016; 152(1): 52–59.
  21. Włodarek K, Ponikowska M, Matusiak Ł, et al. Biologics for hidradenitis suppurativa: an update. Immunotherapy. 2019; 11(1): 45–59.
  22. Ingram JR, Collier F, Brown D, et al. British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (acne inversa) 2018. Br J Dermatol. 2019; 180(5): 1009–1017.
  23. Lee RA, Eisen DB. Treatment of hidradenitis suppurativa with biologic medications. J Am Acad Dermatol. 2015; 73(5 Suppl 1): S82–S88.
  24. Blok JL, Li K, Brodmerkel C, et al. Ustekinumab in hidradenitis suppurativa: clinical results and a search for potential biomarkers in serum. Br J Dermatol. 2016; 174(4): 839–846.
  25. Gulliver WP, Jemec GBE, Baker KA. Experience with ustekinumab for the treatment of moderate to severe hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2012; 26(7): 911–914.
  26. Matusiak Ł, Szczęch J, Bieniek A, et al. Increased interleukin (IL)-17 serum levels in patients with hidradenitis suppurativa: Implications for treatment with anti-IL-17 agents. J Am Acad Dermatol. 2017; 76(4): 670–675.
  27. Casseres RG, Prussick L, Zancanaro P, et al. Secukinumab in the treatment of moderate to severe hidradenitis suppurativa: Results of an open-label trial. J Am Acad Dermatol. 2020; 82(6): 1524–1526.
  28. Prussick L, Rothstein B, Joshipura D, et al. Open-label, investigator-initiated, single-site exploratory trial evaluating secukinumab, an anti-interleukin-17A monoclonal antibody, for patients with moderate-to-severe hidradenitis suppurativa. Br J Dermatol. 2019; 181(3): 609–611.
  29. Głowaczewska A, Szepietowski JC, Matusiak Ł. Severe hidradenitis suppurativa successfully treated with secukinumab. Dermatol Ther. 2020; 33(6): e13845.
  30. Ribero S, Ramondetta A, Fabbrocini G, et al. Effectiveness of Secukinumab in the treatment of moderate-severe hidradenitis suppurativa: results from an Italian multicentric retrospective study in a real-life setting. J Eur Acad Dermatol Venereol. 2021; 35(7): e441–e442.
  31. Extension Study to Assess Effects of Non-interrupted Versus Interrupted and Long Term Treatment of Two Dose Regimes of Secukinumab in Subjects With Hidradenitis Suppurativa. Case Medical Research. 2019.
  32. Study of Efficacy and Safety of Two Secukinumab Dose Regimens in Subjects With Moderate to Severe Hidradenitis Suppurativa (HS) (SUNRISE). Identifier: NCT03713632. 2022. https://clinicaltrials.gov/ct2/show/NCT03713632?term=secukinumab&cond=Hidradenitis+Suppurativa&draw=2&rank=3.
  33. This is a Study of Efficacy and Safety of Two Secukinumab Dose Regimens in Subjects With Moderate to Severe Hidradenitis Suppurativa (HS). (SUNSHINE). Identifier: NCT03713619. 2022. https://clinicaltrials.gov/ct2/show/NCT03713619?term=secukinumab&cond=Hidradenitis+Suppurativa&draw=2&rank=4.
  34. Casseres RG, Kahn JS, Her MJi, et al. Guselkumab in the treatment of hidradenitis suppurativa: A retrospective chart review. J Am Acad Dermatol. 2019; 81(1): 265–267.
  35. Safety and Pharmacokinetics of Repeat Doses of CSL324 in Subjects With Hidradenitis Suppurativa and Palmoplantar Pustulosis. Identifier: NCT03972280. 2021. https://clinicaltrials.gov/ct2/show/NCT03972280?term=csl324&cond=Hidradenitis+Suppurativa&draw=2&rank=1.
  36. A Study Investigating Long-term Treatment With Spesolimab in People With a Skin Disease Called Hidradenitis Suppurativa Who Completed a Previous Clinical Trial. Identifier: NCT04876391. 2022. https://clinicaltrials.gov/ct2/show/NCT04876391?term=spesolimab&cond=Hidradenitis+Suppurativa&draw=2&rank=2.
  37. A Study to Evaluate the Efficacy and Safety of Imsidolimab (ANB019) in the Treatment of Subjects With Hidradenitis Suppurativa. Identifier: NCT04856930. 2021. https://clinicaltrials.gov/ct2/show/NCT04856930?term=imsidolimab&cond=Hidradenitis+Suppurativa&draw=2&rank=1.
  38. A Study to Assess Disease Activity and Safety of Subcutaneous Lutikizumab (ABT-981) in Adult Participants With Moderate to Severe Hidradenitis Suppurativa Who Have Failed Anti-Tumor Necrosis Factor (TNF) Therapy. Identifier: NCT05139602. 2022. https://clinicaltrials.gov/ct2/show/NCT05139602.
  39. A Study of Bermekimab for the Treatment of Participants With Moderate to Severe Hidradenitis Suppurativa (LYRA). Identifier: NCT04988308. 2022. https://clinicaltrials.gov/ct2/show/NCT04988308?term=bermekimab&cond=hidradenitis+suppurativa&draw=2&rank=2.
  40. A Study of Oral Upadacitinib Tablet Compared to Placebo in Adult Participants With Moderate to Severe Hidradenitis Suppurativa to Assess Change in Disease Symptoms. Identifier: NCT04430855. 2021. https://clinicaltrials.gov/ct2/show/NCT04430855?term=upadacitinib&cond=hidradenitis+suppurativa&draw=2&rank=1.
  41. A Study to Test the Efficacy and Safety of Bimekizumab in Study Participants With Moderate to Severe Hidradenitis Suppurativa (BE HEARD II). Identifier: NCT04242498. 2022. https://clinicaltrials.gov/ct2/show/NCT04242498?term=bimekizumab&cond=hidradenitis+suppurativa&draw=2&rank=2.
  42. A Study to Evaluate the Efficacy and Safety of Bimekizumab in Study Participants With Moderate to Severe Hidradenitis Suppurativa (BE HEARD I). Identifier: NCT04242446. 2022. https://clinicaltrials.gov/ct2/show/NCT04242446?term=bimekizumab&cond=hidradenitis+suppurativa&draw=2&rank=3.