School of Medicine and Health Sciences Poster Presentations

Title

Longitudinal outcomes of Hidradenitis Suppurativa patients enrolled in the WE-HEAL Study

Poster Number

129

Document Type

Poster

Publication Date

3-2016

Abstract

Introduction

Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory disease of apocrine sweat glands, characterized by recurrent abscessing inflammation. The prevalence is around 1-4% in young adults. Despite the prevalence of HS in the US, it is largely unstudied, and treatment is extrapolated from studies done in a northern European population.

Molecular drivers of HS are poorly understood, and traditional disease modifying anti-rheumatic (DMARD) therapies have been largely ineffective. However, targeted biologic therapies including TNF-α inhibitors have been used with some success. Adjuvant biologic therapy after radical resection has been shown to reduce risk of recurrence in HS.

The purpose of this study is to analyze the outcomes of patients with HS enrolled in the WE-HEAL Study and to assess how treatment with biologic agents affects disease activity scores including Hidradenitis Sartorius Score (HSS) and Hurley Stage in a US population.

Methods

This research was conducted through the Wound Etiology and Healing Study (WE-HEAL Study), a biospecimen and data repository approved by The George Washington University IRB (041408). All subjects gave written informed consent for longitudinal collection of their data while they received treatment according to standard of care. Data from 561 patients enrolled in the WE-HEAL study was used for this analysis, 59 were HS patients and 502 were patients with chronic wounds used for demographic comparisons including age, sex, race, and smoking status. In the HS cohort, response of HSS and Hurley Stage were analyzed according to medication exposures.

Results

In the WE-HEAL study, HS patients were significantly younger than patients with chronic wounds (40.1 ± 14.21 years compared to 62.3 ± 13.44, p=0.0001). Patients with HS were more likely to be female (66.1% compared to 48.9%, p=0.0086), African American (73% compared to 35%, p=0.0001), and active smokers (27.1% compared to 14.9%, p=0.005).

HSS score and Hurley Grade were higher in current and past smokers than in never smokers (p<0.001). There was no significant difference in HSS score or Hurley grade in the subjects treated with finasteride. However, in patients treated with TNF-α inhibitors there was a significant improvement in mean HSS score (34.92 to 18.76, p<0.001).

Conclusion

The cohort of HS patients followed in the WE-HEAL study is more representative of the population affected in the US with a higher prevalence of women and African Americans. Treatment with TNF-α inhibitors was associated with significant improvement in disease activity scores in this population.

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Creative Commons License
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Open Access

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Presented at: GW Research Days 2016

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Longitudinal outcomes of Hidradenitis Suppurativa patients enrolled in the WE-HEAL Study

Introduction

Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory disease of apocrine sweat glands, characterized by recurrent abscessing inflammation. The prevalence is around 1-4% in young adults. Despite the prevalence of HS in the US, it is largely unstudied, and treatment is extrapolated from studies done in a northern European population.

Molecular drivers of HS are poorly understood, and traditional disease modifying anti-rheumatic (DMARD) therapies have been largely ineffective. However, targeted biologic therapies including TNF-α inhibitors have been used with some success. Adjuvant biologic therapy after radical resection has been shown to reduce risk of recurrence in HS.

The purpose of this study is to analyze the outcomes of patients with HS enrolled in the WE-HEAL Study and to assess how treatment with biologic agents affects disease activity scores including Hidradenitis Sartorius Score (HSS) and Hurley Stage in a US population.

Methods

This research was conducted through the Wound Etiology and Healing Study (WE-HEAL Study), a biospecimen and data repository approved by The George Washington University IRB (041408). All subjects gave written informed consent for longitudinal collection of their data while they received treatment according to standard of care. Data from 561 patients enrolled in the WE-HEAL study was used for this analysis, 59 were HS patients and 502 were patients with chronic wounds used for demographic comparisons including age, sex, race, and smoking status. In the HS cohort, response of HSS and Hurley Stage were analyzed according to medication exposures.

Results

In the WE-HEAL study, HS patients were significantly younger than patients with chronic wounds (40.1 ± 14.21 years compared to 62.3 ± 13.44, p=0.0001). Patients with HS were more likely to be female (66.1% compared to 48.9%, p=0.0086), African American (73% compared to 35%, p=0.0001), and active smokers (27.1% compared to 14.9%, p=0.005).

HSS score and Hurley Grade were higher in current and past smokers than in never smokers (p<0.001). There was no significant difference in HSS score or Hurley grade in the subjects treated with finasteride. However, in patients treated with TNF-α inhibitors there was a significant improvement in mean HSS score (34.92 to 18.76, p<0.001).

Conclusion

The cohort of HS patients followed in the WE-HEAL study is more representative of the population affected in the US with a higher prevalence of women and African Americans. Treatment with TNF-α inhibitors was associated with significant improvement in disease activity scores in this population.