Efficacy of High Dose Adalimumab for the Management of Hidradenitis Suppurativa: A Systematic Review.

Adalimumab, a tumour necrosis factor-alpha inhibitor, has demonstrated efficacy in managing hidradenitis suppurativa (HS) at the standard dose of 40 mg weekly; however, many patients do not achieve adequate clinical response with this regimen. This systematic review aimed to evaluate the efficacy and safety of 80 mg weekly adalimumab in HS management. Four studies, with a total of 67 patients, were reviewed. The studies reported improvements in HS disease severity and quality of life measures with the use of high-dose adalimumab. Adverse events were infrequent and generally mild, with no severe adverse events reported. The findings suggest a favourable response to high-dose adalimumab for patients with severe or refractory HS; however, definitive conclusions are limited by the scarcity and low quality of the available data. Further high-quality research with standardised outcome measures and longer follow-up are needed to validate the role of dose intensification in HS management.