Features of Patients With Crohn’s Disease and Hidradenitis Suppurativa

Kamal, Natasha; Cohen, Benjamin L.; Buche, S.; Delaporte, E.; Colombel, Jean–Frédéric

doi:10.1016/j.cgh.2015.04.180

Cited by 39 publications

(25 citation statements)

References 43 publications

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“…It should be noted that, although the investigator classified Verneuil's disease (Hidradenitis suppurativa (HS)) as "possibly" linked to treatment, this disease was previously shown to be associated with CD in 17% of patients [19]. Those authors suggested that the link between HS and CD could be stronger than expected, because HS is typically underdiagnosed in the IBD population [20].…”

Section: Discussionmentioning

confidence: 99%

Safety of P28GST, a Protein Derived from a Schistosome Helminth Parasite, in Patients with Crohn’s Disease: A Pilot Study (ACROHNEM)

Capron

Béghin

Leclercq

et al. 2019

JCM

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Despite the development of novel therapies, inflammatory bowel diseases remain an innovative treatment challenge. Helminth therapy is a new promising approach, and a key issue is the identification of helminth-derived anti-inflammatory mediators. P28 glutathione-S-transferase (P28GST), a protein derived from schistosomes, a trematode parasitic helminth, was shown to reduce intestinal inflammation in experimental colitis by down-regulating the Th1/Th17 response. In this multicenter, open-label, pilot Phase 2a study, we evaluated the safety of P28GST administered to patients with mild Crohn's disease (CD). We enrolled 10 patients with a baseline Crohn's disease activity index (CDAI) value <220. Eight patients received two to three subcutaneous injections of recombinant P28GST with adjuvant. This three-month treatment was followed by a nine-month monitoring period. The primary endpoints were the monthly rate and seriousness of adverse events (AEs). Secondary endpoints were clinical recurrence, assessed with the CDAI as well as the levels of immunologic and inflammatory blood and tissue markers. The most common AEs were local or regional events at the injection site and gastrointestinal disorders. At three months after the first injection, CDAI scores and blood calprotectin levels decreased in parallel. These results indicate that P28GST showed promise as a safe and new therapeutic option for treating CD.

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Section: Discussionmentioning

confidence: 99%

Safety of P28GST, a Protein Derived from a Schistosome Helminth Parasite, in Patients with Crohn’s Disease: A Pilot Study (ACROHNEM)

Capron

Béghin

Leclercq

et al. 2019

JCM

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“…In patients with chronic perianal and perineal HS, and in particular in the presence of fistulas, the possibility of Crohn's disease should be considered 21 (evidence level 5, grade of recommendation D).…”

Section: Consensus (100%)mentioning

confidence: 99%

Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group

Zouboulis

Bechara

Dickinson-Blok

et al. 2018

Acad Dermatol Venereol

200

291

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Hidradenitis suppurativa (HS)/acne inversa is a debilitating chronic disease that remains poorly understood and difficult to manage. Clinical practice is variable, and there is a need for international, evidence-based and easily applicable consensus on HS management. We report here the findings of a systematic literature review, which were subsequently used as a basis for the development of international consensus recommendations for the management of patients with HS. A systematic literature review was performed for each of nine clinical questions in HS (defined by an expert steering committee), covering comorbidity assessment, therapy (medical, surgical and combinations) and response to treatment. Included articles underwent data extraction and were graded according to the Oxford Centre for Evidence-based Medicine criteria. Evidence-based recommendations were then drafted, refined and voted upon, using a modified Delphi process. Overall, 5310 articles were screened, 171 articles were analysed, and 65 were used to derive recommendations. These articles included six randomized controlled trials plus cohort studies and case series. The highest level of evidence concerned dosing recommendations for topical clindamycin in mild disease (with systemic tetracyclines for more frequent/widespread lesions) and biologic therapy (especially adalimumab) as second-line agents (following conventional therapy failure). Good-quality evidence was available for the hidradenitis suppurativa clinical response (HiSCR) as a dichotomous outcome measure in inflammatory areas under treatment. Lower-level evidence supported recommendations for topical triclosan and oral zinc in mild-to-moderate HS, systemic clindamycin and rifampicin in moderate HS and intravenous ertapenem in selected patients with more severe disease. Intralesional or systemic steroids may also be considered. Local surgical excision is suggested for mild-to-moderate HS, with wide excision for more extensive disease. Despite a paucity of good-quality data on management decisions in HS, this systematic review has enabled the development of robust and easily applicable clinical recommendations for international physicians based on graded evidence.

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“…Moreover, compared to the general population, patients with IBD are 9 times more likely to develop HS (incidence rate ratio of 8.9) 73. Perianal disease is the most common feature in patients with both HS and Crohn disease, while the majority of ulcerative colitis patients who developed HS did so after colectomy, in the setting of pouchitis 74. HS has also been reported to be associated with pyoderma gangrenosum (PG) which is also frequently linked to IBD 75.…”

Section: Comorbiditiesmentioning

confidence: 99%

Hidradenitis suppurativa: from pathogenesis to diagnosis and treatment

Napolitano¹,

Megna²,

Тимощук³

et al. 2017

CCID

186

164

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease primarily affecting apocrine gland-rich areas of the body and presenting with painful nodules, abscesses, sinus tracts, and scarring. HS is a multifactorial disease in which genetic and environmental factors play a key role. The primary defect in HS pathophysiology involves follicular occlusion of the folliculopilosebaceous unit, followed by follicular rupture, and immune responses (perifollicular lympho-histiocytic inflammation), finally leading to the development of clinical HS lesions. HS has a destructive impact on the patient’s quality of life, being a very challenging disease. Available treatments are limited, mostly off-label and with high variability in the reported efficacy. Fortunately, a monoclonal antibody against tumor necrosis factor alpha has been recently approved for treatment of moderate to severe HS, offering patients a promising new option. This review focuses on the main features of HS, including epidemiology, clinical aspects, pathogenesis, severity classifications, comorbidities, and currently available treatments.

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Features of Patients With Crohn’s Disease and Hidradenitis Suppurativa

Cited by 39 publications

References 43 publications

Safety of P28GST, a Protein Derived from a Schistosome Helminth Parasite, in Patients with Crohn’s Disease: A Pilot Study (ACROHNEM)

Safety of P28GST, a Protein Derived from a Schistosome Helminth Parasite, in Patients with Crohn’s Disease: A Pilot Study (ACROHNEM)

Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group

Hidradenitis suppurativa: from pathogenesis to diagnosis and treatment

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