An Anti-Interleukin-17A Monoclonal Antibody, Ixekizumab, in the Treatment of Resistant Hidradenitis Suppurativa: A Case Series

Abstract

<b><i>Introduction:</i></b> Although adalimumab is the only approved biologic for the treatment of hidradenitis suppurativa (HS), the treatment response may not be satisfactory in all patients. Recently, many other biological agents, including interleukin 17 inhibitors such as ixekizumab, have shown promise. <b><i>Case Presentations:</i></b> Five severe HS (Hurley stage III) patients resistant to conventional treatments and adalimumab for at least 3 months were recruited. Patients were prescribed ixekizumab with a scheme approved for psoriasis (160 mg once, followed by 80 mg at weeks 2, 4, 6, 8, 10, and 12.) The primary outcome measure was achieving the Hidradenitis Suppurativa Clinical Response (HiSCR) score following 12 weeks. Secondary outcome measures included the patient-reported Dermatology Life Quality Index (DLQI) and visual analog scale (VAS). Four of 5 patients (80%) achieved HiSCR. While improvement was observed in the VAS and DLQI scores of 4 patients, the decline was limited in 1 patient. No adverse event was recorded related to ixekizumab. <b><i>Conclusion:</i></b> The result of our observation suggests that ixekizumab may be effective for HS, especially in challenging cases.

Certolizumab pegol in the treatment of severe hidradenitis suppurativa after adalimumab failure: A real‐life experience

“…2 Recent studies on the pathogenesis of HS have shown that the patients with HS have imbalances in the T helper 17/interleukin (IL)-17 axis. [10][11][12] However, they may exacerbate inflammatory bowel disease or induce a new-onset condition. 13,14 One patient in our cohort had Crohn's disease, and thus, anti-IL-17 agents could not be considered.…”

“…Recent studies on the pathogenesis of HS have shown that the patients with HS have imbalances in the T helper 17/interleukin (IL)‐17 axis 10–12 . However, they may exacerbate inflammatory bowel disease or induce a new‐onset condition 13,14 .…”

S2k-Leitlinie zur Therapie der Hidradenitis suppurativa/Acne inversa (ICD-10-Code: L73.2)

“…Bei 5 HS/AI-Patienten mit schwerer Manifestation der Erkrankung, die seit mindestens 3 Monaten auf konventionelle Behandlungen und Adalimumab nicht oder nicht mehr ansprachen, wurde Ixekizumab (160 mg s. c. einmalig, gefolgt von 80 mg in den Wochen 2, 4, 6, 8, 10 und 12) verabreicht 408 . Vier der 5 Patienten beobachteten eine Verbesserung der VAS- und DLQI-Werte, der Rückgang bei einem Patienten war begrenzt 408 . Es wurde kein unerwünschtes Ereignis im Zusammenhang mit Ixekizumab festgestellt.…”

“…Bimekizumab wird als subkutane Injektion verabreicht.IxekizumabIxekizumab ist ein humanisierter monoklonaler Antikörper gegen das Zytokin Interleukin-17A (IL-17A), welcher für die Therapie der HS/AI nicht zugelassen ist. Bei 5 HS/AI-Patienten mit schwerer Manifestation der Erkrankung, die seit mindestens 3 Monaten auf konventionelle Behandlungen und Adalimumab nicht oder nicht mehr ansprachen, wurde Ixekizumab (160 mg s. c. einmalig, gefolgt von 80 mg in den Wochen 2, 4, 6, 8, 10 und 12) verabreicht[408]. Vier der 5 Patienten beobachteten eine Verbesserung der VAS-und DLQI-Werte, der Rückgang bei einem Patienten war begrenzt[408].…”

Adalimumab, Ustekinumab, and Secukinumab in the Management of Hidradenitis Suppurativa: A Review of the Real-Life Experience

“…Esme et al reported on a case series of five patients with severe HS (Hurley stage III) who had been on adalimumab treatment for 3 months with poor results, these patients were switched to ixekizumab according to the psoriasis therapeutic schedule of administration. 77 The primary endpoint was HiSCR after 12 weeks. The secondary endpoints were DLQI and VAS.…”