Adalimumab for the Treatment of Moderate to Severe Hidradenitis Suppurativa

Kimball, Alexa B.; Kerdel, Francisco A.; Adams, David R.; Mrowietz, Ulrich; Gelfand, Joel M.; Gniadecki, Robert; Prens, Errol P.; Schlessinger, Joel; Zouboulis, Christos C.; Zee, Hessel H. van der; Rosenfeld, Marie R.; Mulani, Parvez; Gu, Yihua; Paulson, Susan K.; Okun, Martin; Jemec, Gregor B. E.

doi:10.7326/0003-4819-157-12-201212180-00004

Cited by 375 publications

(388 citation statements)

References 26 publications

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“…Adams et al showed no difference in outcome from the placebo group [22]. Another study on etanercept showed 30% no change, 30% long term disease improvement and effectiveness, and a 30% requiring additional dosing after 1 year for recurrence of disease; a similar efficacy rate was also observed by Lee et al at 20% [23,24].…”

Section: Immunomodulatorssupporting

confidence: 57%

Hidradenitis Suppurativa

Lim¹

2013

Anaplastology

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PsychologyHidradenitis causes profound quality of life issues. This is due to chronic pain, odor, drainage, and illness. The result is days of work lost, low self-confidence, impaired sexual health, and even depression in some patients. Most of the disability of HS stems from the soreness and pain of the lesions [9]. A study by Matusiak et al. revealed that of the 30 employed patients, 58.1% had reported absence from work caused by HS, and during the 2 year follow up period, 10% were let go due to the frequency of their absences [10].Of particular importance, it was demonstrated that patients with HS suffer more sexual dysfunction compared to age, gender, and BMI matched controls [1]. Interestingly, it was found that women report greater sexual distress than men with HS of similar severity [1]. This may indicate that female patients with hidradenitis should be screened more closely for sexual dysfunction [1].Additionally, a survey-based study by Von Der Werth and Jemec found that hidradenitis led to lower quality of life scores than other chronic skin conditions such as psoriasis and acne [9]. Depression is more prevalent in sufferers of HS as well, Vazquez et al. found that over 40% of patients with HS had a diagnosis of depression [1,11]. Thus, it would be prudent for physicians to have a lower threshold when considering referral for psychological evaluation. Overall, improvements in management of this disease would likely relieve many of these psychological sequelae. Associated FactorsAlthough the precise etiology of HS remains unclear, there are a number of associated factors that have been consistently described. Many of these pre-disposing factors have insufficient or inconclusive evidence to support them. Of the factors that are well-established associations, strong evidence to explain causation remains lacking.There is a well-recognized association between cigarette smoking and HS [1]. Cross-sectional analyses have demonstrated a strong epidemiologic correlation, with study populations reporting from 70% to as high as 90% of disease sufferers being documented smokers. Some studies have demonstrated remission of disease with smoking cessation, while others show decreased rates of recurrence of disease after surgical resection with concomitant smoking cessation post-operatively.The role of sex hormones has been extensively reported but a clear consensus has not been reached on this topic. Evidence of hormonal

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Section: Immunomodulatorssupporting

confidence: 57%

Hidradenitis Suppurativa

Lim¹

2013

Anaplastology

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“…These include genetic predisposition, hormonal dysregulation and an aberrant immune response to commensal bacteria 7, 8, 9, 10. A number of exogenous influences have also been implicated in population‐based studies of HS, particularly smoking and obesity,11 although a causative relationship has not been established.…”

Section: Introductionmentioning

confidence: 99%

A cross‐sectional epidemiological study of hidradenitis suppurativa in an Irish population (SHIP)

Delany

Gormley

Hughes

et al. 2017

Acad Dermatol Venereol

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BackgroundHidradenitis suppurativa (HS), a chronic inflammatory disease that affects apocrine gland–bearing skin, has a significant impact on patients' quality of life. Estimates of the epidemiologic prevalence of HS are highly variable, and clinical data on disease characteristics and patient burden of disease remain limited.ObjectiveThe primary objective of this study was to determine the number of patients with HS attending dermatology clinics in a hospital setting in Ireland (within a 6‐month time period). Secondary objectives included the assessment of disease characteristics and the collection of patient responses on disease burden and work productivity.MethodsThis was an epidemiologic, non‐interventional, cross‐sectional study across four dermatology clinics in Ireland over a 6‐month time period. The disease prevalence was estimated by calculating the percentage of total patients with a diagnosis of HS (the primary population) across the selected sites. Secondary analyses were performed using the full analysis set, which consisted of eligible adults (≥18 years of age) from the primary population who provided informed consent. Data from these analyses are presented as descriptive summary statistics, with the use of an analysis of covariance for continuous endpoints.ResultsThe prevalence of HS across the four selected sites was estimated at 1.4% (95% CI, 1.24–1.62). One hundred and fifty eligible patients comprised the full analysis set. The majority of participants were white (95.3%), female (70.0%), cigarette smokers (56.0%) and overweight or obese (body mass index ≥25 kg/m2, 81.8%). Most patients for whom data were available presented with Hurley stage II (50.4%), and more than a third of the full analysis set had a relative with HS (34.7%). Questionnaire responses revealed a profound impact on quality of life, including diminished work productivity and various psychological comorbidities.ConclusionThis study offers insight into the clinical features and disease burden of hidradenitis suppurativa in an Irish population.

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“…Relapszus ezen betegnél 6 esetben hat hónapon belül, míg 8 esetben több mint egy év eltelté-vel jelentkezett. Isotretinoinnal kapcsolatosan ezen szisztematikus összefoglalóban hét vizsgálat szerepel, melyek során összesen 174 beteget kezeltek 0,5-1,2 mg/kg/nap dózisban 4-12 hónapig (38) (39)(40)(41)(42). A rendelkezésre álló evidenciák alapján az adalimumab és az infliximab hatásos kezelések a betegségben, javítják a betegek életminőségét.…”

Section: áBraunclassified

Hidradenitis suppurativa: why isn’t it a form of acne?

Törőcsik¹,

Kinyó²,

Kovács³

et al. 2016

BVSZ

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ÖSSZEFOGLALÁSKey words: acne inversa, acne vulgaris, hidradenitis suppurativa 1. Patogenezis Acne inversa: miért nem acne és nem is hidradenitis?A betegség korábbi nevével, az acne inversával joggal leszámolva, hisz nem ott, nem akkor és nem úgy jelenik meg, mint a serdülőkori acne, sokak számára a jellegzetes lokalizációból adódóan egyértelmű patogenetikai tényező-ként az apokrin mirigyek foglalták el a központi helyet. A tünetek típusos intertriginózus megjelenése kétséget kizá-róan rámutat az adott terület jellegzetességeinek szerepére, melyek nagyban hozzájárulhatnak a betegség kialakulásá-hoz. Számos elmélet született már, részleges magyarázatot adva a hidradenitis suppurativa (HS) patogenezisére, mint például a fokozott mechanikai irritáció szerepe, vagy a terület eltérő higiénés jellemzői, immunológiai sajátossá-gai, melyben a fokozott nedvesség kaphat központi szerepet. Ugyanakkor a szövettani vizsgálatok alapján az apokrin mirigyek csak az előrehaladott formákban voltak érint-ve és akkor is sokkal inkább a végpontjai mint sem aktív szereplői voltak a patológiai folyamatoknak (1).Az utóbbi évek kutatásai a faggyúmirigyek szerepére is ráirányították a figyelmet, melyhez nagyban hozzájárultak azok a szövettani leletek, melyek a faggyúmirigyek elpusztulását már a HS kezdeti stádiumában leírták (2). A szövet-tani minták elemzésének másik szembetűnő lelete az acné-ből jól ismert follicularis hiperkeratinizáció/okklúzió volt, mely a folliculusok kitágulásához majd roncsolódásához vezet, így a baktériumokban gazdag törmelék a dermist infiltrálva annak gyulladását eredményezi felvetve, hogy a baktériumok és a különböző gyulladásos útvonalak éppúgy fontosak lehetnek ebben a betegségben is (1. ábra). A gyulladásban szerepet játszó sejteken az acnéban ismerthez hasonlóan, szintén fokozottan vannak jelen a Toll-like 129

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Adalimumab for the Treatment of Moderate to Severe Hidradenitis Suppurativa

Abstract: Abbott Laboratories.

Cited by 375 publications

References 26 publications

Hidradenitis Suppurativa

Hidradenitis Suppurativa

A cross‐sectional epidemiological study of hidradenitis suppurativa in an Irish population (SHIP)

Hidradenitis suppurativa: why isn’t it a form of acne?

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