Background Adalimumab is an antibody against tumour necrosis factor-α currently indicated for moderate to severe hidradenitis suppurative (HS).
Purpose To assess the effectiveness and safety of adalimumab in patients with HS.
Material and methods A retrospective study of patients with HS and treated with adalimumab was developed. Measured variables included: age, sex, previous treatment and regimen therapy. Primary effectiveness endpoint was Hidradenitis Suppurativa Clinical Response (proportion of patients with reduction ≥75% in total abscess and inflammatory nodule from baseline, AN75) at 24 and 48 weeks. Secondary endpoints were: Hurley Stages (with three clinical stages: the highest stage more severe) and Hidradenitis Suppurativa-Physician’s Global Assessment (HS-PGA, with six ranges from clear to very severe) from baseline. Adverse reactions (RA) and withdrawal treatments associated were recorded to evaluate safety.
Results Thirty-one patients with a mean age 43 (14–65) years were included (16 females). Infliximab was a previous treatment in 12 (40%) patients. Treatment regimen was: 80 mg at week 0 followed by 40 mg at week 1, and 40 mg every other week via subcutaneous in 29 (93.6%) patients and 80 mg at week 0 followed by 40 mg weekly in two (6.4%) patients. There were eight increments frequency to 40 mg weekly.
Baseline Hurley were: three (9.7%) patients Hurley-I, four (12.9%) Hurley-II and 24 (77.4%) Hurley-III. Baseline HS-PGA were: one (3.2%) patient minimal, two (6.4%) mild, six (19.4%) moderate, 14 (45.2%) severe and eight (25.8%) very severe. Twenty-eight patients were evaluated (three withdrawal treatments by RA: one arthropathy, one abdominal pain and one vision disorder).
At week 24, 85.7% achieved AN75. Secondary endpoints were: 24 (85.7%) patients Hurley-I and four (14.3%) Hurley-III; HS-PGA: 24 (85.7%) patients were clear and four (14.3%) severe.
At week 48, 71.4% achieved AN75. Secondary endpoints were: 21 (75%) patients Hurley-I, one (3.6%) Hurley-II and six (21.4%) Hurley-III; HS-PGA: 20 (71.4%) patients clear, two (7.1%) moderate, one (3.6%) severe and five (17.9%) very severe.
Twenty-six RA were recorded in 17 (54.8%) patients: five (19.2%) abdominal pain, five (19.2%) hyperglycaemia, four (15.4%) leukocytosis and 12 (46.2%) others. The RA leading to withdrawal treatments were: one arthropathy, one abdominal pain and one vision disorder.
Conclusion Adalimumab showed an improvement in clinical endpoints in the most patients with HS at week 24 and 48. More than half of patients recorded RA, mainly abdominal pain and hyperglycaemia. Some RA lead to withdrawal of treatments.
No conflict of interest
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