Longitudinal observational study of hidradenitis suppurativa: impact of surgical intervention with adjunctive biologic therapy.
Document Type
Journal Article
Publication Date
1-1-2018
Journal
International journal of dermatology
Volume
57
Issue
1
DOI
10.1111/ijd.13798
Keywords
Adalimumab; Adult; Analgesics, Opioid; Biological Products; Combined Modality Therapy; Dermatologic Agents; Female; Hidradenitis Suppurativa; Humans; Infliximab; Longitudinal Studies; Male; Middle Aged; Prospective Studies; Severity of Illness Index; Time Factors; Treatment Outcome; Ustekinumab
Abstract
BACKGROUND: Hidradenitis supppurativa (HS) is a chronic inflammatory disease of the apocrine sweat glands affecting 1-4% of the population. While surgical excision is a mainstay of therapy, lesions often recur. Biologic therapies, including tumor necrosis factor-α and IL-12/23 inhibitors, are effective for mild to moderate HS. However, longitudinal studies investigating biologic therapy in conjunction with surgery are limited. The purpose of this analysis was to investigate impact of surgery and biologic therapy on HS disease activity.
METHODS: Data from 68 HS patients were analyzed. Outcome measures included hidradenitis suppurativa Sartorius Score (HSS), active nodule (AN) count, Hurley stage, and probability of achieving 75% reduction in active nodule count (AN75).
RESULTS: Mean age was 40 ± 14 years; 66% were female and 72% were African American. Mean disease duration was 10 years, and Hurley stage III disease was seen in 63% of patients. Patients who received biologics had a larger drop in HSS and AN count than those who never received biologics (P = 0.002). Biologic treatment was associated with average reduction in 22 (15-29) HSS points (P < 0.0001). The effect of biologics was greater in patients who also underwent surgery (P = 0.013). Timing of biologics relative to surgery did not impact efficacy. Patients who received HS surgery with biologic therapy were most likely to achieve the AN75 (P = 0.017).
CONCLUSIONS: In this diverse cohort of patients with severe HS, biologic therapy was associated with a more rapid decline in disease activity, with the greatest effect in patients who also underwent HS surgery.
APA Citation
Shanmugam, V. K., Mulani, S., McNish, S., Harris, S., Buescher, T., & Amdur, R. (2018). Longitudinal observational study of hidradenitis suppurativa: impact of surgical intervention with adjunctive biologic therapy.. International journal of dermatology, 57 (1). http://dx.doi.org/10.1111/ijd.13798
Peer Reviewed
1
Open Access
1
Comments
This is an open access PubMed Central article.