Long-term adalimumab treatment of hidradenitis suppurativa: Results and practical insights from a real-life experience

Bettoli, Vincenzo; Manfredini, Marco; Calamo, Giada; Forconi, Riccardo; Bencivelli, Dario; Mantovani, Lucia; Pellacani, Giovanni; Corazza, Monica

doi:10.1111/dth.12737

Cited by 26 publications

(26 citation statements)

References 6 publications

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“…Regarding clinical characteristics, in line with grouping criteria, eligible patients had more inflammatory nodules and abscesses than non- Our results show high response rates to adalimumab in agreement with previous research on adalimumab real-life use 35,36 , Table 4. Other studies showed lower adalimumab effectiveness 37,38 .…”

Section: Discussionsupporting

confidence: 91%

Clinical selection criteria in new clinical trials of hidradenitis suppurativa: External validity and implications on the daily clinical practice

Montero‐Vílchez

Salvador‐Rodríguez

Sánchez‐Díaz

et al. 2020

Dermatologic Therapy

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Introduction: There are an increasing number of biologic drugs in the pipeline for treating hidradenitis suppurativa (HS). Clinical trials for these drugs usually share the same clinical selection criteria. Objectives: (a) To describe the clinical profile of HS patients receiving first-line biologic treatment in an HS clinic setting, (b) to assess how this population would meet clinical criteria to participate in a clinical trial, and (c) to assess treatment effectiveness at week 16 in eligible vs non-eligible patients. Methods: Prospective observational study. Patients were grouped according to their eligibility for clinical trials. The effectiveness of adalimumab was assessed by HiSCR, IHS4-category-change and a-50%-reduction on IHS4 at week 16. Results: Thirty-eight patients were included in the study: eight (21.05%) were eligible for clinical trials and 30 (78.95%) were not. The main reason for non-eligibility was not having an AN count ≥5. Both groups presented similar number of draining tunnels. Effectiveness at week 16 was lower in non-eligible than eligible patients when evaluated by HiSCR-response but similar if evaluated by the IHS4-category-change or the 50%-reduction in IHS4. Conclusion: In our population, the external validity of current eligibility criteria for clinical trials is low. Most patients receiving adalimumab in real-life setting would not be eligible for clinical trials.

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Section: Discussionsupporting

confidence: 91%

Clinical selection criteria in new clinical trials of hidradenitis suppurativa: External validity and implications on the daily clinical practice

Montero‐Vílchez

Salvador‐Rodríguez

Sánchez‐Díaz

et al. 2020

Dermatologic Therapy

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“…Concerning the treatment [10], different pharmacological options are available, ranging from antibiotics (such as clindamycin, rifampicin or tetracyclines) to biologics (like Adalimumab or Infliximab) [11,12,13]. However, drugs have side-effects and are, in some cases, interrupted, being not well-tolerated by patients [10].…”

Section: Introductionmentioning

confidence: 99%

The Safety and Impact of a Model of Intermittent, Time-Restricted Circadian Fasting (“Ramadan Fasting”) on Hidradenitis Suppurativa: Insights from a Multicenter, Observational, Cross-Over, Pilot, Exploratory Study

et al. 2019

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Hidradenitis suppurativa (HS) is a chronic-relapsing and debilitating disease, which affects the components of the folliculopilosebaceous unit and severely impacts on the perceived health-related quality of life. Among the possible treatments, dietary interventions, such as fasting, have been described to positively impact on HS. However, nothing is known about the effects of circadian, intermittent fasting, such as the Ramadan fasting. A sample of 55 HS patients (24 males (43.6%) and 31 females (56.4%), mean age 39.65 ± 8.39 years, average disease duration 14.31 ± 7.03 years) was recruited in the present study. The “Severity of International Hidradenitis Suppurativa Severity Score System” (IHS4) decreased significantly from 11.00 ± 5.88 (before Ramadan) to 10.15 ± 6.45 (after Ramadan), with a mean difference of −0.85 ± 0.83 (p < 0.0001). At the univariate analyses, the improvement was associated with HS phenotype (with a prominent improvement among those with ectopic type), treatment (with the improvement being higher in patients receiving topical and systemic antibiotics compared to those treated with biologics), the “Autoinflammatory Disease Damage Index” (ADDI), and Hurley scores. At the multivariate regression analysis, only the Hurley score (regression coefficient = 0.70, p = 0.0003) was found to be an independent predictor of change in the IHS4 score after fasting. The improvement in the IHS4 score was not, however, associated with weight loss. In conclusion, the Ramadan fasting proved to be safe and effective in HS patients. Considering the small sample size and the exploratory nature of the present investigation, further studies in the field are warranted, especially longitudinal, prospective and randomized ones.

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“…Multiple treatments have been described for the management of HS patients (Alikhan et al, ; ; Bettoli, Manfredini, Calamo, et al, ; Bettoli, Manfredini, Massoli, et al, ). Surgical approaches are a quite common therapeutic modality for severe HS, even though postsurgical management is usually more complex with respect to other because of the large areas involved and of the ongoing inflammatory process in the adjacent involved skin areas (Garbarino, Manfredini, Rossi, & Magnoni, ).…”

Section: Introductionmentioning

confidence: 99%

Surgical and postsurgical wound care in hidradenitis suppurativa

Manfredini

Garbarino

Bigi

et al. 2020

Dermatologic Therapy

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Hidradenitis suppurativa (HS) is a chronic inflammatory disorder. Several medical treatments, with varying degree of efficacy, have been developed. However, in most cases of advanced (HS), the definitive treatment option is often represented by surgical excisions. Surgical techniques, reconstructive approach, and local wound care should be accurately designed in order to obtain the best result. In this letter, we analyzed the possible surgical treatments and local wound care. A literature review was performed on the various surgical treatments, reconstructive techniques, and local wound care. Surgical treatment is a common therapeutic modality for HS. Different surgical reconstructive techniques and postsurgical wound care approaches are described for the management of HS patients. There were few high‐quality evidence‐based studies evaluating the surgical management of HS. Many disparate HS severity scores were used in these studies making comparison between them difficult. Nonetheless, research into different surgical approaches and wound care management has increased substantially in the past decade and has given patients more surgical therapeutic strategies. The description of the best combinations and timing of surgery, wound care and medical therapies, will be a matter of future research for the definition of the optimal management of HS patient.

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Long-term adalimumab treatment of hidradenitis suppurativa: Results and practical insights from a real-life experience

Cited by 26 publications

References 6 publications

Clinical selection criteria in new clinical trials of hidradenitis suppurativa: External validity and implications on the daily clinical practice

Clinical selection criteria in new clinical trials of hidradenitis suppurativa: External validity and implications on the daily clinical practice

The Safety and Impact of a Model of Intermittent, Time-Restricted Circadian Fasting (“Ramadan Fasting”) on Hidradenitis Suppurativa: Insights from a Multicenter, Observational, Cross-Over, Pilot, Exploratory Study

Surgical and postsurgical wound care in hidradenitis suppurativa

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