Increased Doses of Adalimumab are Associated With Clinical Improvement of Hidradenitis Suppurativa

June 2023 | Volume 22 | Issue 6 | 615 | Copyright © June 2023


Published online May 10, 2023

Jazzmin Williams BSa, Claudia Guzik BSb, Akhil Wadhera MDc, Haley Naik MD MHScd

aSchool of Medicine, University of California San Francisco, San Francisco, CA
bCollege of Medicine, Drexel University, Philadelphia, PA
cDepartment of Dermatology, Kaiser Permanente Fremont Medical Center, Fremont, CA
dDepartment of Dermatology, University of California San Francisco, San Francisco, CA

tunneling and fibrosis. Although we assessed symptom improvement using subjective patient reports rather than validated surveys, pain is the single-most bothersome symptom associated with HS.9  Thus improved pain, drainage, and quality of life may constitute markers of HS treatment response until improved measures are developed. 

Despite sample size limitations and retrospective chart-review design, our findings support use of increased doses of adalimumab to achieve better disease control for overweight and obese HS patients and provide further justification for future randomized controlled trials examining weight-based dosing of adalimumab. Appropriately-dosed disease-modifying treatments prescribed early in disease course may have a role in preventing disease progression to irreversible scarring and disfigurement.10,11 Thus, for patients with this debilitating disease, improvements in the availability and effectiveness of treatment regimens are critical for improving quality of life.

DISCLOSURES

Dr. Haley Naik has received grant support from AbbVie; consulting fees from 23andme, Abbvie, Aristea Therapeutics, Nimbus Therapeutics, Medscape, Sonoma Biotherapeutics, DAVA Oncology, Boehringer Ingelheim, Union Chimique Belge’s (UCB) and Novartis; and investigator fees from Pfizer; and she holds shares in Radera, Inc. She is also an Associate Editor for JAMA Dermatology and a board member of the Hidradenitis Suppurativa Foundation.

Authors Williams, Guzik, and Wadhera have no disclosures to report.  

REFERENCES

  1. Kimball AB, Okun MM, Williams DA, et al. Two phase 3 trials of adalimumab for hidradenitis suppurativa. N Engl J Med. 2016;375:422-434.
  2. Choi F, Lehmer L, Ekelem C, et al. Dietary and metabolic factors in the pathogenesis of hidradenitis suppurativa: a systematic review. Int J Dermatol. 2020;59:143-153.
  3. Bechara FG, Podda M, Prens EP, et al. Efficacy and safety of adalimumab in conjunction with surgery in moderate to severe hidradenitis suppurativa: The SHARPS randomized clinical trial. JAMA Surg. 2021;156:1001-1009.
  4. Zouboulis CC, Hansen H, Caposiena Caro RD, et al. Adalimumab dose intensification in recalcitrant hidradenitis suppurativa/acne inversa. Dermatology. 2019;1-6.
  5. Sánchez Martínez E m., Murray G, Alfageme Roldán F, et al. Adalimumab dose intensification in hidradenitis suppurativa: effectiveness and safety results of a multicentre study. Br J Dermatol. 2021;185:863-865.
  6. Bouguen G, Laharie D, Nancey S, et al. Efficacy and safety of adalimumab 80 mg weekly in luminal crohn’s disease. Inflamm Bowel Dis. 2015;21:1047-53.
  7. Singh S, Facciorusso A, Singh AG, et al. Obesity and response to anti-tumor necrosis factor-α agents in patients with select immune-mediated inflammatory diseases: A systematic review and meta-analysis. PloS One. 2018;13:e0195123.
  8. Thorlacius L, Garg A, Riis PT, et al. Inter‐rater agreement and reliability of outcome measurement instruments and staging systems used in hidradenitis suppurativa. Br J Dermatol. 2019;181:483-491.
  9. Garg A, Neuren E, Cha D, et al. Evaluating patients’ unmet needs in hidradenitis suppurativa: Results from the Global Survey Of Impact and Healthcare Needs (VOICE) Project. J Am Acad Dermatol. 2020;82:366-376.
  10. Paek SY, Hamzavi I, Danby FW, et al. Disease modification for hidradenitis suppurativa: A new paradigm. J Am Acad Dermatol. 2017;76:772-773.
  11. Marzano A v., Genovese G, Casazza G, et al. Evidence for a ‘window of opportunity’ in hidradenitis suppurativa treated with adalimumab: a retrospective, real-life multicentre cohort study. Br J Dermatol. 2021;184(1):133-40.

AUTHOR CORRESPONDENCE

Haley B. Naik MD MHSc haley.naik@ucsf.edu
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