Hidradenitis Suppurativa Review

07/24/2018

A review of recent news, research, and treatment related to hidradenitis suppurativa.

HS

Antibiotic May Help Treat Refractory HS

Patients with severe refractory hidradenitis suppurativa (HS) may benefit from ertapenem (Invanz) therapy, according to the findings of a recent study. 

In the retrospective study, the researchers examined medical charts of 36 patients with Hurley stage 2 or 3 HS who were treated with intravenous ertapenem between March 2013 and December 2016 (22 were female). Additionally, the researchers conducted telephone interviews that included questions on satisfaction, quality of life changes, and disease state changes while receiving ertapenem therapy.

Overall, 35 (97.2%) patients experienced improvements in HS while receiving ertapenem therapy. Of the 28 patients who participated in the phone interviews, 20 (71.4%) were very satisfied or satisfied and 85.7% experienced improvements in quality of life.

“Following ertapenem therapy, patients reported improvements in quality of life,” the researchers concluded. “This treatment appears promising as an adjunct to biologics or as a bridge to surgery in the treatment of severe, refractory HS.” 

Reference

Braunberger TL, Nartker NT, Nicholson CL, et al. Ertapenem–a potent treatment for clinical and quality of life improvement in patients with hidradenitis suppurativa [published online May 17, 2018]. Int J Dermatol. doi:10.1111/ijd.14036

Biologic Safe for Long-Term Use   

A recent extension study demonstrated long-term safety and efficacy of adalimumab (Humira) for the treatment of moderate to severe hidradenitis suppurativa (HS).

In their study, the researchers pooled data from the PIONEER phase 3 trials and an open-label extension study that included patients with HS. The duration of PIONEER I/II periods A and B were 12 and 24 weeks, respectively, and the duration of the open-label extension period was 52 weeks or more. Participants involved in the open-label extension period received 40 mg of adalimumab every week continuously (ADAew) and responders plus partial responders (PRR) were evaluated. The primary endpoints included HS Clinical Response (HiSCR) measure, lesion counts, skin pain, and Dermatology Life Quality Index (DLQI), as well as treatment-emergent adverse events. 

At week 12, 52.3% (ADAew) and 73% (PRR) of participants achieved HiSCR, reported the researchers, which was maintained through week 168 by 52.3% of ADAew participants and 57.1% of PRR participants. In addition, the researchers observed sustained improvement in lesion counts, skin pain, and DLQI. The safety profile of adalimumab was similar between the open-label extension study and PIONEER studies.

“Continuous weekly dosing with adalimumab 40 mg is a reasonable treatment option for long-term control of moderate to severe HS,” the researchers concluded. 

Reference

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 [published online May 31, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.05.040 

gut

HS Linked to Increased Risk for Crohn Disease

Patients with hidradenitis suppurativa (HS) are at an increased risk for developing Crohn disease, according to the findings of a recent study published online in JAMA Dermatology.

In the cross-sectional study, the researchers identified 51,340 patients with HS using electronic health records data from the Explorys multiple health system data analytics and research platform and 18,455,600 controls. The diagnosis of Crohn disease was assessed as the primary outcome.

The prevalence of Crohn disease was 2% among patients with HS compared with 0.6% among those without HS.

Additional univariable and multivariable analyses showed that patients with HS had a 3.29 (95% CI, 3.09-3.50) and a 3.05 (95% CI, 2.87-3.25) higher odds of developing Crohn disease, respectively, compared with those without HS.

Patients who were white (2.3%), aged 45 to 64 years (2.4%), nonobese (2.8%), and tobacco smokers (2.3%) had the highest prevalence of Crohn disease. While Crohn disease was associated with HS across all patient subgroups, the association was strongest for men (odds ratio [OR], 3.61; 95% CI, 3.24-4.03), patients aged 45 to 64 years (OR, 3.49; 95% CI, 3.16-3.85), nonobese patients (OR, 4.09; 95% CI, 3.69-4.54), and nonsmokers (OR, 3.44; 95% CI, 3.10-3.82).

“These data suggest that patients with HS are at risk for Crohn disease,” the researchers concluded. “Gastrointestinal symptoms or signs suggestive of Crohn disease warrant additional evaluation by a gastroenterologist.” 

Reference

Garg A, Hundal J, Strunk A. Overall and subgroup prevalence of Crohn disease among patients with hidradenitis suppurativa: a population-based analysis in the United States [published online May 23, 2018]. JAMA Dermatol. doi:10.1001/jamadermatol.2018.0878