[New drug therapy approaches in the management of hidradenitis suppurativa].

BACKGROUND

Hidradenitis suppurativa (HS) is a chronic, relapsing, immune-mediated inflammatory disease of the terminal hair follicle unit, characterized by inflamed nodules, abscesses, draining tunnels, scarring, pain, and substantial impairment of quality of life. Current guideline-based management is multimodal and combines general measures, pain management, antiseptic and antibiotic strategies, systemic anti-inflammatory therapy, and, where appropriate for selected lesions, surgical procedures. According to European treatment standards, systemic treatment options for moderate-to-severe HS include antibiotics as well as approved biologic therapies, particularly adalimumab and the IL-17-targeted agents secukinumab and bimekizumab.

OBJECTIVE

This narrative review summarizes therapeutic agents currently under clinical investigation for HS. The analysis is primarily based on ClinicalTrials.gov, supplemented by published clinical studies.

RESULTS

The therapeutic pipeline is broad and includes the following: IL-17-, IL-36-, and IL-1-targeted biologics; intracellular kinase inhibitors; dual immunomodulatory antibodies; chemokine-, complement-, and neutrophil-directed strategies; topical agents; PDE4 inhibition; and metabolic approaches.

CONCLUSION

The diversity of emerging therapeutic strategies highlights the persistently high unmet need in HS. These approaches target distinct components of both the adaptive and innate immune systems. Given the immunological heterogeneity of HS, such broad and partly multimodal strategies appear biologically plausible and clinically meaningful. Beyond purely immunologically acting therapies, GLP‑1 receptor agonists represent an interesting complementary approach and may, in combination with immunosuppressive therapies, provide added benefit and generate promising clinical data.