Department of Dermatology, Venereology and Allergology, Medical University, Wroclaw, Poland.
Department of Dermatology, Zealand University Hospital, Health Sciences Faculty, University of Copenhagen, Roskilde, Denmark.
Curr Opin Pharmacol. 2019 Jun;46:65-72. doi: 10.1016/j.coph.2019.04.006. Epub 2019 May 7.
Hidradenitis suppurativa (HS) is a chronic, inflammatory, debilitating disease of a relapsing nature which presents with nodules, abscesses, and suppurating lesions of intertriginous areas of the skin. Within recent years, there has been significant progress in terms of the treatment of HS, nevertheless, an unmet need of treatment exists and effective therapy remains a serious challenge. The current treatment strategies are focused on known pathomechanisms underlying and responsible for development of HS lesions, including hyperkeratinization and occlusion of pilosebaceous unit, dysbiosis and the extensive, chronic inflammation. Several cytokines (i.e. TNF-a, IL-1, IL-17, and IL-23) seem to be involved in HS pathogenesis, and their blockade appears as a rational therapeutic approach. So far TNF inhibition with adalimumab remains the only EMA-approved/FDA-approved agent in HS treatment and should be consequently considered first. Other drugs, however, play an increasing role in off-label therapy. In recent years, new phase II and III trials for HS management have appeared aimed at inhibition of specific targetable inflammatory pathways identified in HS. Thus, several new biologics are being investigated, including MABp1 (bermekimab), CJM112, bimekizumab, guselkumab, secukinumab, and IFX-1.
化脓性汗腺炎（HS）是一种具有复发性的慢性、炎症性、使人虚弱的疾病，其特征为结节、脓肿和化脓性病变，这些病变发生于皮肤的皱褶部位。近年来，HS 的治疗已经取得了显著进展，但仍存在未满足的治疗需求，有效的治疗方法仍然是一个严峻的挑战。目前的治疗策略主要集中在导致 HS 病变的已知发病机制上，包括角化过度和皮脂腺单位的闭塞、微生态失调以及广泛的慢性炎症。几种细胞因子（例如 TNF-α、IL-1、IL-17 和 IL-23）似乎参与了 HS 的发病机制，其阻断似乎是一种合理的治疗方法。到目前为止，阿达木单抗抑制 TNF 仍然是 HS 治疗中唯一获得 EMA 批准/FDA 批准的药物，因此应首先考虑使用。然而，其他药物在标签外治疗中发挥着越来越重要的作用。近年来，出现了一些针对 HS 管理的新的 II 期和 III 期试验，旨在抑制在 HS 中确定的特定靶向炎症途径。因此，正在研究几种新的生物制剂，包括 MABp1（bermekimab）、CJM112、bimekizumab、guselkumab、secukinumab 和 IFX-1。
