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Background Hidradenitis suppurativa is an inflammatory disease of the inverse skin regions that occurs particularly in young women and affects approximately 1% of the population. Outpatient care is often inadequate and usually cannot prevent progression. Objective The aim of the EsmAiL trial was to evaluate whether an innovative care concept can decrease disease activity and burden, as well as improve patient satisfaction. Methods EsmAiL was conducted as a two-arm, multicentre, prospective randomised controlled trial including 553 adults with HS. Inclusion criteria were a minimum of three inflammatory lesions and at least moderate impact of the disease on the quality of life. The control group (CG) remained in standard care, whereas the intervention group (IG) was treated according to a trial-specific, multimodal concept. Primary endpoint was the absolute change in the International Hidradenitis Suppurativa Severity Score System (IHS4). Results 279 patients were randomised to the IG and 274 to the CG. Of those, 377 attended final assessment after 12-month of intervention. Participants in the IG (n=203) achieved a mean improvement in the IHS4 of 9.3 points while the average decrease in the CG patients (n=174) amounted to 5.7 points (p=0.003). Patients receiving the new care concept also reported a significantly (p<0.001) higher decrease in pain, DLQI and HADS compared to changes in the CG. Patient satisfaction was also significantly higher in the IG than in the CG (p<0.001). Conclusion The establishment of standardised treatment algorithms in so-called “acne inversa centres (AiZ)” in the ambulatory setting has a substantial, positive impact on the course of the disease and significantly improves patient satisfaction.

<b><i>Introduction:</i></b> Low skeletal muscle mass (LSMM) can be assessed by cross-sectional imaging. LSMM is associated with several clinically relevant factors in various disorders with predictive and prognostic implications. <b><i>Methods:</i></b> Our aim was to establish the effect of computed tomography (CT)-defined LSMM on mortality in renal cell cancer (RCC) and urothelial carcinoma (UC) undergoing palliative treatment. The MEDLINE library, Cochrane, and SCOPUS databases were screened for the associations between CT-defined LSMM up to May 2022. In total, 11 studies were suitable for the analysis. <b><i>Results:</i></b> The included studies comprised 481 patients with RCC and 394 patients with UC. The pooled hazard ratio for the association between LSMM and overall survival was 1.64 (95% CI: 0.90–2.99), <i>p</i> = 0.10 in univariable analysis and 1.55 (95% CI: 0.91–2.63), <i>p</i> = 0.10 in multivariable analysis for RCC. For UC, the pooled hazard ratio was 2.75 (95% CI: 1.77–4.28), <i>p</i> &#x3c; 0.00001 in univariable, and 2.77 (95% CI: 1.91–4.02), <i>p</i> &#x3c; 0.00001 in multivariable analysis. For progression-free survival, it was 2.02 (95% CI: 1.24–3.27), <i>p</i> = 0.004 for RCC and 2.43 (95% CI: 1.59–3.74), <i>p</i> &#x3c; 0.0001 for UC (univariable analysis). <b><i>Conclusions:</i></b> CT-defined LSMM predicts OS and PFS in RCC and UC in the palliative setting. The effect was higher in UC. Therefore, LSMM assessment should be included as a relevant prognostic biomarker in clinical routine.

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