Metascoring Hidradenitis suppurativa

Daoud, Mathieu; Njimi, Hassane; Benhadou, Farida; Suppa, Mariano; Daxhelet, Mathilde; Karama, Jalila; White, Jonathan M. L.; Jemec, Gregor B. E.; Marmol, Véronique Del

doi:10.1111/jdv.17022

Cited by 3 publications

(1 citation statement)

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“…The metascore ( 48 ) is a combination of the other scores mentioned, and is designed to be applied at the cohort (group) level, not at the patient level. Provided that the scores that the investigator wishes to evaluate are known, a cohort of patients could be classified from the most severely affected to the least severely affected patient (static metascore).…”

Section: Resultsmentioning

confidence: 99%

Overview and comparison of the clinical scores in hidradenitis suppurativa: A real-life clinical data

et al. 2023

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IntroductionPartly due to its clinical heterogeneity, hidradenitis suppurativa (HS) is difficult to score accurately; illustrated by the large number of disease scores. In 2016, a systematic review by Ingram et al. reported the use of about thirty scores, and since then, this number has increased further. Our aim is twofold: to provide a succinct but detailed narrative review of the scores used to date, and to compare these scores with each other for individual patients.Materials and methodsThe review of the literature was done among articles in English and French, on Google, Google scholar, Pubmed, ScienceDirect and Cochrane. To illustrate the differences between scores, data from some Belgian patients included in the European Registry for HS were selected. A first series of patients compares the severity of the following scores: Hurley, Hurley Staging refined, three versions of Sartorius score (2003, 2007, 2009), Hidradenitis Suppurativa Physician Global Assessment (HS-PGA), International Hidradenitis Suppurativa Severity Scoring System (IHS4), Severity Assessment of Hidradenitis Suppurativa (SAHS), Hidradenitis Suppurativa Severity Index (HSSI), Acne Inversa Severity Index (AISI), the Static Metascore, and one score that is not specific to HS: Dermatology Life Quality Index (DLQI). A second set of patients illustrates how some scores change over time and with treatment: Hurley, Hurley Staging refined, Sartorius 2003, Sartorius 2007, HS-PGA, IHS4, SAHS, AISI, Hidradenitis Suppurativa Clinical Response (HiSCR), the very new iHS4-55, the Dynamic Metascore, and DLQI.ResultsNineteen scores are detailed in this overview. We illustrate that for some patients, the scores do not predictably and consistently correlate with each other, either in an evaluation of the severity at a time-point t, or in the evaluation of the response to a treatment. Some patients in this cohort may be considered responders according to some scores, but non-responders according to others. The clinical heterogeneity of the disease, represented by its many phenotypes, seems partly to explain this difference.ConclusionThese examples illustrate how the choice of a score can lead to different interpretations of the response to a treatment, or even potentially change the results of a randomized clinical trial.

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Section: Resultsmentioning

confidence: 99%

Overview and comparison of the clinical scores in hidradenitis suppurativa: A real-life clinical data

et al. 2023

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Hidradenitis suppurativa in the elderly: new insights

White,

Del Marmol

2023

British Journal of Dermatology

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Factors Associated with Severe Hidradenitis Suppurativa, Using Hurley Staging and Metascore

Daoud,

Suppa,

Benhadou

et al. 2024

Dermatology

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Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease for which certain risk factors are well known: obesity and smoking (in particular). However, the factors associated with more severe conditions, and therefore potential aggravators of the disease, remain a matter of debate. Our study aims to determine the clinical factors associated with severe HS using several severity scores. Methods: The data were obtained via the ERHS questionnaire from patients exclusively recruited at Erasme Hospital in Brussels. The severity of HS was firstly estimated by the Hurley score, and secondly by a metascore, a system combining the iHS4, HS-PGA, SAHS, and DLQI. Univariable and multivariable analyses were performed. Results: Six hundred and forty-seven patients were included in the Hurley analysis, and 456 patients in the metascore analysis. In multivariable analysis, men have a more severe metascore than women (odds ratio [OR] = 1.89, p = 0.022), smoking was associated with a more severe disease according to metascore, especially in mild cases (OR = 0.76, p = 0.043), and an elevated body mass index was associated with having Hurley stage III disease compared to Hurley I or II disease (OR = 1.09, p = 0.001). A significant association is also shown between blood pressure and Hurley stage (OR = 0.97, p = 0.025). Self-reports of nonsteroidal anti-inflammatory drugs aggravating the disease is also a factor associated with greater severity according to the metascore (OR = 0.12, p = 0.008). Finally, several locations of HS lesions were associated with greater severity, in particular the armpits according to the metascore (OR = 0.29, p < 0.001), and the perianal area according to the Hurley score (OR = 0.15, p < 0.001). Conclusion: HS seems to be more severe in men; smoking seems to aggravate mild cases of HS, while increased body mass index plays a major role in the transition from Hurley II to Hurley III.

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Metascoring Hidradenitis suppurativa

Cited by 3 publications

References 10 publications

Overview and comparison of the clinical scores in hidradenitis suppurativa: A real-life clinical data

Overview and comparison of the clinical scores in hidradenitis suppurativa: A real-life clinical data

Hidradenitis suppurativa in the elderly: new insights

Factors Associated with Severe Hidradenitis Suppurativa, Using Hurley Staging and Metascore

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