Increased Doses of Adalimumab are Associated With Clinical Improvement of Hidradenitis Suppurativa.

BACKGROUND

TNF-inhibitor adalimumab 40 mg/week (ADA40) is the only approved treatment for hidradenitis suppurativa (HS); however, it is not uniformly effective. Despite a high prevalence of comorbid obesity in HS patients, adalimumab dosing is not weight-based, unlike other TNF-inhibitors.

OBJECTIVE

To evaluate the effectiveness of adalimumab 80 mg/week (ADA80) compared with ADA40 in overweight and obese patients with moderate to severe HS.

METHODS

We conducted a dual-center retrospective chart review of HS patients treated with ADA80 between August 2016 and December 2021. We collected data on demographics, comorbidities, treatments, and disease severity that are presented as descriptive statistics and compared with Wilcoxon signed-rank test.

RESULTS

Eight patients with median body mass index of 36.6 (IQR 32.5–40.7) and no improvements in HS severity on ADA40 were prescribed ADA80. Patients experienced improved HS-Physician Global Assessment (ADA40: median 3.0 (3.0-3.8); ADA80: (2.0 (1.8, 2.0)) (P=0.01)), all 5 patients who had lesion counts documented achieved HS Clinical Response, and all 8 patients reported symptom improvements.

CONCLUSIONS

Increased adalimumab dose may be associated with improved outcomes for overweight and obese patients with moderate to severe HS. J Drugs Dermatol. 2023;22(6) doi:10.36849/JDD.6868.