How long do patients with hidradenitis suppurativa gain benefit from biologic drugs?

Linked Article: Prens et al. Br J Dermatol 2021; 185:177–184. Hidradenitis suppurativa is a chronic skin disease in which persistent, painful, boil‐like lesions develop especially in the armpits and groin. Treatment is often difficult, and patients with severe disease are eligible for so‐called biologic therapy. The only registered biologic agent is adalimumab, a monoclonal antibody to the inflammatory mediator called tumour necrosis factor‐α (TNF‐α), although other biologic agents such as infliximab (another TNF‐α antagonist) have been used. Unfortunately, these agents may lose their effect with time, sometimes because the patient develops antibodies to the drug, or side‐effects may develop. Little is known about the long‐term results of using these treatments in patients with hidradenitis suppurativa. In this paper, the authors from Groningen and Rotterdam in the Netherlands retrospectively studied the long‐term effectiveness and tolerability of adalimumab and infliximab in patients attending either centre with hidradenitis suppurativa. They studied 104 patients who received adalimumab 40 mg weekly or 80 mg fortnightly, the recommended dose regimen. They also studied 44 patients who were treated with infliximab 5 mg/kg every 6 to 8 weeks. Of the patients treated with adalimumab, 56·3% were still taking the drug after 1 year, and 30·5% after 2 years. Similarly, 58·3% of patients started on infliximab were still receiving the drug at 1 year, and 48·6% at 2 years. Loss of effectiveness was the chief reason for stopping the drug, although some patients developed side‐effects, particularly to infliximab. Only a few patients were tested for antibodies, which were detected in roughly a half. Generally, older patients or those with a longer disease history were more likely to persist with adalimumab therapy. The authors noted that patients with hidradenitis were less likely to persist with biologic therapy than patients with other disease indications such as psoriasis, spondyloarthritis and Crohn disease. Linked Article: Prens et al. Br J Dermatol 2021; 185:177–184. [ABSTRACT FROM AUTHOR]