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Dermatology. 2019 Oct 18:1-6. doi: 10.1159/000503606. [Epub ahead of print]

Adalimumab Dose Intensification in Recalcitrant Hidradenitis Suppurativa/Acne Inversa.

Author information

1
Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany, christos.zouboulis@mhb-fontane.de.
2
European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany, christos.zouboulis@mhb-fontane.de.
3
Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany.
4
European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany.
5
Department of Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
6
Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
7
Dr. Isabelle Delorme Inc., Drummondville, Québec, Canada.
8
Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain.
9
Department of Dermatology, Reims University Hospital, University of Champagne-Ardenne, Reims, France.
10
Second Department of Dermatology and Venereology, General Hospital Papageorgiou, Aristotle University of Thessaloniki, Thessaloniki, Greece.
11
Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
12
Department of Dermatology, University Hospital Puerta De Hierro Majadahonda, Madrid, Spain.

Abstract

BACKGROUND:

Adalimumab is the only approved compound for the treatment of adult patients with moderate-to-severe hidradenitis suppurativa (HS) who did not respond to a systemic classical treatment. Despite its significant short- and long-term efficacy, a percentage of patients do not respond sufficiently. Moreover, some primary responders experience a response loss with time.

OBJECTIVE:

To analyse the effectiveness of adalimumab dose intensification in HS patients.

METHODS:

A case series of adalimumab 80 mg/week subcutaneously (s.c.) compassionate use in patients with HS, who did not respond sufficiently or in primary responders with progressive response loss to the registered adalimumab dose of 40 mg/week s.c. Patients were collected and evaluated retrospectively. Patients' data were extracted from medical records.

RESULTS:

The 14 patients collected were Caucasian with HS of Hurley stage II-III and moderate or severe International HS Severity Score System (IHS4) stage. Adalimumab dose intensification significantly improved IHS4 score, Pain Index, HS-Physician Global Assessment, pain, and Cardiff Dermatology Life Quality Index. Two young female patients with HS and Crohn's disease developed psoriatic lesions during the treatment with adalimumab 80 mg/week s.c.

CONCLUSION:

An enhanced level of effectiveness was assessed in the majority of the HS patients treated with adalimumab dose intensification (80 mg/week s.c.). Larger studies are required to evaluate this observation.

KEYWORDS:

Acne inversa; Adalimumab; Hidradenitis suppurativa; Intensification; Treatment

PMID:
31630144
DOI:
10.1159/000503606

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