Upcoming novel treatments for hidradenitis suppurativa: An overview of the pipeline.

Recent developments in hidradenitis suppurativa (HS) have focused on targeting key inflammatory pathways implicated in the pathogenesis of the disease, including interleukin (IL)-17, IL-1, tumour necrosis factor (TNF), Janus kinase (JAK) and tyrosine kinase 2 (TYK2) signalling as well as innate immune mechanisms such as neutrophil activation and complement pathways. Novel biologics, dual cytokine-inhibition strategies and bispecific agents represent an emerging therapeutic paradigm. Small-molecule inhibitors, including JAK1 and TYK2 inhibitors, offer the potential advantage of oral administration and broader immunomodulatory effects. Therapies targeting alternative mechanisms, including B-cell modulation, complement inhibition, chemokine signalling and intracellular pathways, are also being actively investigated. While some agents have shown encouraging results in selected HS trials, including responses at higher thresholds, such as IHS4-75 or IHS4-90, findings remain heterogeneous. Some trials have not met their primary endpoints, highlighting the challenges of translating mechanistic rationale into consistent clinical benefit. Overall, the expanding therapeutic pipeline in HS reflects a shift towards precision medicine and pathway-specific interventions. This review aims to summarize the upcoming treatments in hidradenitis suppurativa and to outline the future therapeutic landscape of the disease.