Skin health and disease · 2026
Efficacy and safety of two interleukin-17 inhibitors (bimekizumab and secukinumab) in the management of hidradenitis suppurativa: a systematic review and meta-analysis of randomized controlled trials.
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Ishkirat Hana, Abarca-Pineda Yozahandy Angeles, Ahmed Arwa, Shamim Fatima, Elremmash Tala, Malik Bilal Haider, Mohsin Moaz, Deeksha F N U, Jeswin Teenu Maria, Kaur Amandeep, Alsubari Asma'a Munasar Ali, Ayyan Muhammad
Аннотация
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that primarily affects the intertriginous regions, causing manifestations such as inflammatory nodules, abscesses and scarring.
OBJECTIVES: To systematically evaluate the efficacy and safety of interleukin (IL)-17 inhibitors, including bimekizumab and secukinumab, for the treatment of moderate-to-severe HS based on evidence from randomized controlled trials (RCTs).
METHODS: We searched various electronic databases, including MEDLINE (via PubMed), Embase and CENTRAL to retrieve RCTs on the use of two IL-17 inhibitors (bimekizumab and secukinumab) for the management of HS. Dichotomous outcomes were reported as relative risk (RR) with 95% confidence intervals (CIs), and continuous outcomes were reported as mean difference (MD) with 95% CIs.
RESULTS: Our meta-analysis included 5 RCTs with a total of 2188 patients. According to our analysis, IL-17 inhibitors significantly increased the proportion of patients with HiSCR50 (Hidradenitis Suppurativa Clinical Response) (RR 1.45, 95% CI 1.26-1.66) and HiSCR75 (RR 2.03, 95% CI 1.42-2.90). IL-17 inhibitors significantly increased the proportion of patients with Hidradenitis Suppurativa Symptom Daily Diary (HSSDD) worst skin pain response (RR 2.46, 95% CI 1.41-4.30). The IL-17 inhibitor group was associated with a statistically significant decrease in HSSDD worst skin pain score from baseline compared with the placebo group (MD -1.02, 95% CI -1.44 to -0.60). The intervention group was also associated with a statistically significant decrease in Dermatology Life Quality Index score from baseline compared with the placebo group (MD -1.77, 95% CI -2.54 to -0.99). The treatment-emergent adverse events were similar in both groups.
CONCLUSIONS: IL-17 inhibitors are associated with an improvement in clinical response and pain outcomes in patients with moderate-to-severe HS, with an acceptable safety profile in the available studies. Given the limited number of trials with no head-to-head comparisons, further large-scale and independent studies are required to clarify their long-term role, particularly in patients whose HS is refractory to conventional and biologic therapies.
OBJECTIVES: To systematically evaluate the efficacy and safety of interleukin (IL)-17 inhibitors, including bimekizumab and secukinumab, for the treatment of moderate-to-severe HS based on evidence from randomized controlled trials (RCTs).
METHODS: We searched various electronic databases, including MEDLINE (via PubMed), Embase and CENTRAL to retrieve RCTs on the use of two IL-17 inhibitors (bimekizumab and secukinumab) for the management of HS. Dichotomous outcomes were reported as relative risk (RR) with 95% confidence intervals (CIs), and continuous outcomes were reported as mean difference (MD) with 95% CIs.
RESULTS: Our meta-analysis included 5 RCTs with a total of 2188 patients. According to our analysis, IL-17 inhibitors significantly increased the proportion of patients with HiSCR50 (Hidradenitis Suppurativa Clinical Response) (RR 1.45, 95% CI 1.26-1.66) and HiSCR75 (RR 2.03, 95% CI 1.42-2.90). IL-17 inhibitors significantly increased the proportion of patients with Hidradenitis Suppurativa Symptom Daily Diary (HSSDD) worst skin pain response (RR 2.46, 95% CI 1.41-4.30). The IL-17 inhibitor group was associated with a statistically significant decrease in HSSDD worst skin pain score from baseline compared with the placebo group (MD -1.02, 95% CI -1.44 to -0.60). The intervention group was also associated with a statistically significant decrease in Dermatology Life Quality Index score from baseline compared with the placebo group (MD -1.77, 95% CI -2.54 to -0.99). The treatment-emergent adverse events were similar in both groups.
CONCLUSIONS: IL-17 inhibitors are associated with an improvement in clinical response and pain outcomes in patients with moderate-to-severe HS, with an acceptable safety profile in the available studies. Given the limited number of trials with no head-to-head comparisons, further large-scale and independent studies are required to clarify their long-term role, particularly in patients whose HS is refractory to conventional and biologic therapies.