Adalimumab relieves moderate-to-severe hidradenitis suppurativa

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HealthDay News -- Treatment with once-weekly adalimumab improved pain and inflammation among patients with moderate-to-severe hidradenitis suppurativa (HS), study results show.

Patients with HS, a chronic skin disease characterized by painful abscesses, nodules and draining fistulas in the axilla and groin, who were assigned to weekly adalimumab reported statistically significant improvements in outcomes and pain compared to those assigned to placebo, Alexa B. Kimball, MD, MPH, of Harvard Medical School in Boston, and colleagues reported in Annals of Internal Medicine.

The researchers conducted a phase 2 dose-ranging study that involved 154 adult patients with moderate-to-severe HS who did not respond to or who were intolerant of oral antibiotics. Patients were allocated to receive placebo or 40 mg adalimumab every week or every other week (EOW) for 16 weeks.

All patients were switched to EOW at the start of an open-label 36 week phase, while those who had a suboptimal response could switch to weekly dosing at that point. Clinical response was defined as an HS Physician's Global Assessment (PGA) score of clear, minimal or mild with at least a 2-grade improvement relative to baseline at week 16.

Clinical response rates were highest among those who received weekly adalimumab, 17.6%, compared with 9.6% of those who received the every other week dosage and 3.9% of patients assigned to placebo, the researchers found.

Serious adverse events were reported in 7.8% of patients in the weekly adalimumab group, 5.8% in the EOW group and 3.9% in placebo-treated patients. Compared with the placebo group, patients who received weekly adalimumab reported significantly higher improvements in outcomes and pain. Patients who switched from weekly to EOW adalimumab treatment showed a reduction in clinical response.

"This phase 2 dose-ranging study showed evidence of efficacy and tolerability of adalimumab in HS," the researchers wrote. "Inflammation and pain were reduced, and impairment of health-related quality of life and work productivity increased."


References

  1. Kimball AB et al. Ann Intern Med. 2012;157(12):846-855.
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