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Which HS Treatment Option Is Associated With Better Response?

A recent chart review found biologic therapy was associated with the most significant treatment response among patients with hidradenitis suppurativa (HS).

“This is the first study to evaluate trends in treatment response of various therapeutic strategies in patients with HS at an academic referral center in Dallas, TX, a unique geographic region of the southern US,” the researchers said. In the retrospective chart review, they analyzed patient demographics, clinical features, prescribed treatments, and response to treatment among 149 patients with HS seen at a faculty general dermatology practice between February 2015 and February 2018.
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Hurley stages I, II, and III were diagnosed in 29.6%, 36.5%, and 33.9% of patients, respectively, the researchers said, with 44.2% of patients reporting a positive family history of HS. In addition, they found 39.5% of patients were current or former smokers and 52.8% reported alcohol use. Among patients with HS, 80.8% were overweight or obese, the researchers observed, which was higher than the general population in Texas in 2016 (68.5%).

Oral antibiotics (83.9%), topical antibiotic therapy (74.5%), metabolic medications such as metformin/zinc (67.1%), intralesional Kenalog (63.1%), and biologic therapies such as tumor necrosis factor (TNF)-α inhibitors (49%), were the most frequently prescribed treatments, they added.

“In examining the response rate, patients with disease localized to the buttocks had significantly higher response rates (60.4% vs 25%) and approached statistical significance in responders versus nonresponders in treatment with biologics when compared against all other treatments,” the researchers said.

While oral and topical antibiotics were the most frequently prescribed therapies in this cohort, the use of TNF-α inhibitors appeared to be associated with the most significant treatment response, they concluded.


Peterson GC, Preston A, Frieder J, Wang X, Paek SY. Analysis of characteristics and trends in treatment response of hidradenitis suppurativa patients: A southern US cohort study [published online Jan 14, 2020]. Dermatology. doi:10.1159/000504843



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