Adalimumab (Humira) appeared to be safe and effective among patients with moderate to severe hidradenitis suppurativa (HS), according to the findings of a recent poster abstract presented at the 2020 American Academy of Dermatology Virtual Meeting Experience.
In the study, the researchers retrospectively analyzed data of 23 patients with moderate to severe HS who visited their dermatology department between September 2015 and August 2019. All patients were treated with adalimumab for at least 3 months, had at least 1 follow-up visit, and enough data to calculate a baseline Hidradenitis Suppurativa Severity Score System (IHS4) score. The mean age of patients included in the study was 38.9± 11.6 years; 7 patients were female; median disease duration was 13.9±8.5 years; and 21 patients received prior treatment, which included oral doxycycline, rifampicin-clindamycin, acitretin, and prednisone. At baseline, the mean IHS4 score was 6.2 ± 4.8.
Clinical response was determined using IHS4 and Hidradenitis Suppurativa Clinical Response (HiSCR) scores. The researchers also analyzed adverse effects associated with treatment.
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The mean duration of treatment was 13.3 ±8.2 months, with 11 patients receiving a maintenance treatment of 40 mg per week and 12 receiving maintenance treatment of 80 mg every other week. Twelve patients (52.5%) were treated with other systemic therapies while also using adalimumab. Other adjuvant therapies included topical treatments, surgical drainage, and intralesional triamcinolone.
The researchers found a statistically significant decrease in IHS4 scores at 3, 6, and 12 months after treatment compared with baseline scores (ISH4 scores=2, 1.6, and 2, respectively). In addition, 16 of 21 patients achieved HiSCR after 3 months, 10 of 15 achieved HiSCR after 6 months, and 6 of 12 achieved HiSCR after 12 months of treatment, they added.
At the end of the study period, 16 patients were still being treated with adalimumab, the researchers wrote. Five patients withdrew from treatment due to secondary failure, and 1 patient discontinued treatment after achieving a complete sustained response. In addition, only 1 patient, a 24-year-old man, discontinued treatment due to anti–TNF-induced lupus arthritis, the researchers noted.
“This study confirms that adalimumab significantly reduced HS activity in our daily practice and that it is a safe treatment option,” the researchers concluded. They also noted that 2 main difficulties in the study were because of treatment withdrawal due to secondary failure and loss of effectivity over time among those who continued treatment. “It would be interesting to address the safety and effectiveness of intensification of adalimumab in these settings,” they added.
Moneva-Leniz LM, Garcia-Ruiz R, Sanchez-Martinez EM, et al. Effectiveness of adalimumab in hidradenitis suppurativa: A real-life study. Abstract presented at: 2020 American Academy of Dermatology Virtual Meeting Experience; June 12-14, 2020.