For patients who have the inf lammatory condition hidradenitis suppurativa, only one approved treatment has been available. However, efforts are underway to identify new therapeutic methods that can offer improved outcomes for these individuals, particularly those with more advanced disease.
According to Joslyn Kirby, M.D., a dermatologist with PennState Health Milton S. Hershey Medical Center, Hershey, Penn., the number of clinical trials investigating the efficacy of biologics in treating this condition at Stage 2 and Stage 3 are growing in number and should be considered a front-line treatment option. She discussed current and emerging hidradentitis suppurativa treatment options during the Fall Clinical Dermatology Conference in Las Vegas, October 17-20, 2019.
“We’re learning a vast amount about what’s happening in the skin with patients who have HS,” she says. “We’re looking at all the different cell types and cytokines that play an even greater role so we can modify these contributors to the pain, drainage and the incapacity of hidradenitis suppurativa. We’re hoping for even greater patient outcomes.”
Currently, she says, adalimumab (Humira, Abbvie) is the only medication approved by the Food & Drug Administration to treat hidradenitis suppurativa, and it targets TNF. But, the efforts to pinpoint biologics that can also be used to reduce symptoms are increasing. Between 2017 and 2019, the number of clinical trials devoted to this effort grew by 50%, she says,with many focusing on interleukin-17 and interleukin-23 inhibitors.
Although identifying the right clinical trial and enrolling patients might be difficult, Dr. Kirby says, better outcomes could develop if dermatologists suggest biologic therapy when they first see the scarring and tunneling associated with this condition. Providers and patients can find hidradenitis suppurativa clinical trials by going to bit.ly/HSclinicaltrials.
“The challenge occurs if a patient has inferior responsiveness to adalimumab,” she says. “They must go through a three-month wash-out period before participating in a clinical trail.”