Oral clindamycin and rifampicin combination therapy for hidradenitis suppurativa: a prospective study and 1-year follow-up

Dessinioti, Clio; Zisimou, Chrisa; Tzanetakou, Vassiliki; Stratigos, Alexander J.; Antoniou, Christina

doi:10.1111/ced.12933

Cited by 49 publications

(45 citation statements)

References 20 publications

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“…In this combination, clindamycin is added to overcome the antibiotic resistance against rifampicin, and the dose of clindamycin reaches subtherapeutic levels after 2 weeks of therapy because of cytochrome p450 induction by rifampicin (Albrecht, Baine, Ladizinski, Jemec, & Bigby, 2018). Efficacy of this combination was reported in a few case series and case studies (Dessinioti, Zisimou, Tzanetakou, Stratigos, & Antoniou, 2016;Gener et al, 2009;van der Zee, Boer, Prens, & Jemec, 2009). In one of these reports, patients had a significant reduction in the baseline Sartorius score (Gener et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Hidradenitis suppurativa: Clinical characteristics and determinants of treatment efficacy

Vural

Gündoğdu

Akay

et al. 2019

Dermatologic Therapy

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder that causes a significant decline in quality of life. There are numerous treatment options; however, real‐life data on the efficacy of these treatments is limited. This study was performed in two centers to describe clinical characteristics and assess treatment outcome in a cohort of 139 patients with HS. Data on demographic and clinical characteristics, Hurley stage and comorbidities were collected from patient charts and evaluated retrospectively. Treatment response was measured with HS clinical response index (HISCR). Mean body mass index was 27.8±4.88. Inflammatory comorbidities were present in 23%. Among first‐line drugs systemic doxycycline resulted in 60% HISCR followed by rifampicin–clindamycin combination (46.4%). Isotretinoin had the lowest HISCR (30.7%) in this group. For second‐line therapies, all acitretin treated patients achieved response and patients treated with tumor necrosis factor alpha (TNF‐α) inhibitors had the highest HISCR. Currently recommended first‐line therapies have moderate efficacy in HS. Acitretin appears to be a reasonable alternative for the highly effective TNF‐α inhibitors in patients with severe and resistant HS. Overall, these results support that excessive inflammatory response play an important role in pathogenesis of HS.

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Section: Discussionmentioning

confidence: 99%

Hidradenitis suppurativa: Clinical characteristics and determinants of treatment efficacy

Vural

Gündoğdu

Akay

et al. 2019

Dermatologic Therapy

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“…In contrast to flare, the terms recurrence and relapse were used more frequently in the literature and had a higher proportion of studies with a definition (Table S1; see Supporting Information). [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Again, in contrast to flare, recurrence or relapse were more frequently associated with an increase in HS activity after a surgical intervention. Of the 19 studies that defined either relapse or recurrence, six (32%, six of 19) used the term in association with a medical intervention, while the majority (68%, 13 of 19) used the terms for a surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

A narrative review of the definition of ‘flare’ in hidradenitis suppurativa

et al. 2019

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Summary Background Hidradenitis suppurativa (HS) is a chronic, inflammatory condition that can have periodic worsening or flares. Measurement of flare is important because it can inform treatment efficacy; however, it is unclear how HS flare should be defined. Objectives This study reviewed the literature for definitions of HS flare. Methods The PubMed MEDLINE online database was searched on 10 January 2018 and the search was repeated on 8 December 2018 for new publications. Titles and abstracts were screened for inclusion. Subsequently, full articles were screened for inclusion. Papers were included if the publication was a systematic review, clinical trial, cohort study, case report or series, or cross‐sectional study. Studies were excluded if they were journalistic reviews, did not discuss clinical findings of HS or did not use the words ‘flare’, ‘exacerbation’, ‘relapse’ or ‘recurrence’. Results Two hundred and seventy‐four papers were identified and 154 fulfilled the study criteria. Of these, 27 (17.5%) included the term ‘flare’ and 16 (10.4%) included the term ‘exacerbation’. Two of the 27 papers (7%) defined the term flare and both included patient report of changes in symptoms or signs. One of 16 papers (6%) defined exacerbation, which was taken as one new HS lesion. The terms ‘recurrence’ and ‘relapse’ were more apt to be defined: 13% (13 of 100) and 14% (six of 44), respectively. Conclusions The lack of a specific and measurable definition of HS flare is a barrier to assessment of this important outcome. Once a specific and measurable definition is established, validated and reliable measures of HS flare can be incorporated into future studies. What's already known about this topic? Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory skin condition. The ability to assess flares is important to people who have HS; however, it is unclear how this is defined. HS flare is one of the core outcomes in the core outcome set for HS clinical trials; however, it is unclear how this should be assessed. What does this study add? This literature review reveals the paucity of measurable definitions associated with the use of the term ‘flare’ in the HS literature. It also highlights the variation and lack of a validated and reliable measure of HS flare.

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“…given in combination with rifampicin [600 mg daily given as either 1 or 2 doses] for 10 weeks) has proved beneficial, with variable results 83–87. In a study conducted by van der Zee et al, 47% of HS patients receiving systemic clindamycin/rifampicin treatment reported total remission after 10 weeks, while an additional 35% of subjects experienced at least some improvement, whereas another survey reported that 70/116 patients (~70%) had significant improvement after 10 weeks of treatment 83,85.…”

Section: Treatmentmentioning

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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Oral clindamycin and rifampicin combination therapy for hidradenitis suppurativa: a prospective study and 1-year follow-up

Abstract: Oral clindamycin with oral rifampicin for 12 weeks is an effective and tolerable regimen for HS.

Cited by 49 publications

References 20 publications

Hidradenitis suppurativa: Clinical characteristics and determinants of treatment efficacy

Hidradenitis suppurativa: Clinical characteristics and determinants of treatment efficacy

A narrative review of the definition of ‘flare’ in hidradenitis suppurativa

Hidradenitis suppurativa: from pathogenesis to diagnosis and treatment

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