Improvement of overlapping hidradenitis suppurativa and ankylosing spondylitis after the introduction of adalimumab

Abstract

Hidradenitis suppurativa is a chronic inflammatory disorder characterized by occlusion of the follicular pilosebaceous units of the skin. The treatment options are sometimes very limited and unpleasant odor and abundant drainage complicate the disease. Ankylosing spondylitis is a form of seronegative spondyloarthritis with predominantly axial but also peripheral joint involvement. Both of the conditions lower the patient’s quality of life and affect everyday activities.We describe a 39-year-old male patient with both diseases treated with different medications with only a modest result. After the initiation of a tumor necrosis factor α (TNF-α) inhibitor (adalimumab) the patient experienced first the musculoskeletal and later on the skin improvement. The introduction of TNF-α inhibitors should be considered early in the treatment of overlapping hidradenitis suppurativa and the spondyloarthritis spectrum of conditions. Available medical data confirm the positive results and beneficial effect on disease course, activity and, most importantly, quality of life.

North American clinical management guidelines for hidradenitis suppurativa: A publication from the United States and Canadian Hidradenitis Suppurativa Foundations

“…107,108 Early case reports and open-label trials demonstrated mixed results. [51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66]109,110 In 4 larger placebo-controlled trials, adalimumab, 40 mg every other week, failed to achieve primary efficacy end points. [48][49][50] A subsequent phase 2 double-blinded trial randomized 154 patients to adalimumab 40 mg every other week, 40 mg weekly, or placebo.…”

Biologics for Hidradenitis Suppurativa: An Update

“…In the majority of studies, ADA was administered with the dosing regimen previously adopted for the treatment of psoriasis (80 mg at week 0, 40 mg at week 1 and then 40 mg every other week) [22]. The effects were satisfactory in accordance to both efficacy and safety of the treatment [21,[23][24][25][26][27][28][29][30][31][32][33]. In subsequent years, prospective studies based on larger groups and longer observation of patients were published.…”

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

“… 36–39 There are also cases of HS associated with ankylosing spondylitis, Crohn’s disease, pyoderma gangrenous, acne and psoriatic arthritis successfully treated with adalimumab. 40–46 Main articles regarding the use of adalimumab for the management of hidradenitis suppurativa in real-life setting are reported in Table 1 .…”