7938 Faculty of Medicine, University of Toronto, Canada.
12362 Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada.
J Cutan Med Surg. 2022 Mar-Apr;26(2):176-180. doi: 10.1177/12034754211049711. Epub 2021 Sep 29.
There is currently at least 1 biologic (adalimumab) approved in North America for treatment of Hidradenitis Suppurativa in the pediatric population. However, no reviews or clinical trials have specifically analyzed the effectiveness and safety data of biologic use in this population. The objective of this systematic review is to identify and summarize the outcomes of biologic therapy in pediatric patients with HS.
MEDLINE and EMBASE databases were used to conduct the search on Sept 18, 2020.
The 15 included studies consisted of 26 patients, with the mean age of 15 ± 2.3 years. Females accounted for 53.8% ( = 14/26) of cases. The mean duration of HS prior to biologic initiation was 3.5 ± 2.9 years, with the majority having Hurley Stage II. The 26 patients received 34 biologics in total: 85.3% treated with TNF alpha inhibitors (adalimumab = 17, infliximab = 10, etanercept = 1, unspecified = 1), 5.9% with IL-12/23 inhibitors (ustekinumab = 2), 5.9% with IL-1 inhibitors (i.e., anakinra = 2) and 2.9% received IL-23 inhibitors (i.e., guselkumab = 1) biologics. Of the 26 patients, 23.1% ( = 6/26) experienced complete resolution (CR), 73.1% ( = 19/26) experienced partial resolution (PR), and 3.8% ( = 1/26) had no resolution outcomes reported. The time to resolution of HS lesions after biologic initiation ranged from 10 days to 11.5 months (mean: 5.1 months). No adverse events were reported in the studies.
Although anti-TNF alpha were the most common biologics used for HS in pediatric cases, large-scale trials specific to pediatric patients with HS are needed to confirm these findings.
目前，北美至少有一种生物制剂（阿达木单抗）被批准用于治疗儿童人群的化脓性汗腺炎。然而，尚无专门分析此类人群使用生物制剂的有效性和安全性数据的综述或临床试验。本系统评价的目的是确定并总结生物制剂治疗化脓性汗腺炎患儿的结果。
于 2020 年 9 月 18 日，通过 MEDLINE 和 EMBASE 数据库进行检索。
纳入的 15 项研究共包含 26 例患者，平均年龄为 15 ± 2.3 岁。女性占 53.8%（14/26）。开始使用生物制剂前化脓性汗腺炎的平均病程为 3.5 ± 2.9 年，大多数患者 Hurley 分期为 II 期。26 例患者共接受了 34 种生物制剂治疗：85.3%接受 TNF-α抑制剂（阿达木单抗 17 例，英夫利昔单抗 10 例，依那西普 1 例，未特指 1 例），5.9%接受 IL-12/23 抑制剂（乌司奴单抗 2 例），5.9%接受 IL-1 抑制剂（阿那白滞素 2 例），2.9%接受 IL-23 抑制剂（古塞库单抗 1 例）。26 例患者中，23.1%（6/26）完全缓解（CR），73.1%（19/26）部分缓解（PR），3.8%（1/26）无缓解结局报道。生物制剂治疗开始后，化脓性汗腺炎皮损缓解的时间范围为 10 天至 11.5 个月（平均：5.1 个月）。研究中未报告不良事件。
虽然抗 TNF-α是治疗儿童化脓性汗腺炎最常用的生物制剂，但仍需开展针对儿童化脓性汗腺炎患者的大规模临床试验来证实这些发现。
