Department of Dermatology, St Vincent's University Hospital, Dublin, Ireland.
UCD School of Medicine, University College Dublin, Dublin, Ireland.
Clin Exp Dermatol. 2023 Jul 7;48(7):790-792. doi: 10.1093/ced/llad130.
Hidradenitis suppurativa (HS) is characterized by increased interleukin (IL)-17A/C/F. Two open-label trials of brodalumab, an IL-17 receptor antagonist, have been completed, with 8 of 10 patients receiving brodalumab fortnightly and 10 of 10 patients receiving brodalumab weekly achieving 75% Hidradenitis Suppurativa Clinical Response. All patients were biologic 'experienced' but were not reported to have failed biologic treatment. We report outcomes for eight patients with HS who had failed at least one biologic, treated with brodalumab 210 mg fortnightly, to provide real-world evidence. Four of eight patients remain on brodalumab, with a mean treatment duration of 11.3 months. All patients who remain on brodalumab subjectively report continued treatment efficacy. The mean Dermatology Life Quality Index reduced from 20.6 to 16.8 at week 16. All patients required concurrent antibiotics due to flares. Brodalumab may be effective in patients who have previously failed multiple biologics, but efficacy in our real-world study falls short of the two open-label trials. This may reflect severe treatment-resistant disease. In the absence of further licensed treatments for HS, brodalumab may be a good option following adalimumab failure.
化脓性汗腺炎（HS）的特征是白细胞介素（IL）-17A/C/F 增加。两种白细胞介素-17 受体拮抗剂布罗达卢单抗的开放性试验已经完成，接受布罗达卢单抗每两周一次治疗的 10 名患者中有 8 名，接受布罗达卢单抗每周一次治疗的 10 名患者中有 10 名达到 75%的化脓性汗腺炎临床应答。所有患者均为生物制剂“经验”患者，但未报告生物制剂治疗失败。我们报告了 8 名接受布罗达卢单抗治疗的 HS 患者的结果，这些患者至少接受过一种生物制剂治疗失败，布罗达卢单抗每两周 210mg 治疗，提供真实世界的证据。8 名患者中有 4 名仍在接受布罗达卢单抗治疗，平均治疗持续时间为 11.3 个月。所有仍在接受布罗达卢单抗治疗的患者均主观报告继续治疗有效。在第 16 周时，皮肤病生活质量指数（Dermatology Life Quality Index，DLQI）的平均值从 20.6 降至 16.8。所有患者均因发作需要同时使用抗生素。布罗达卢单抗可能对先前接受多种生物制剂治疗失败的患者有效，但我们的真实世界研究的疗效不如两项开放性试验。这可能反映了严重的治疗抵抗性疾病。在没有进一步的化脓性汗腺炎许可治疗的情况下，阿达木单抗治疗失败后，布罗达卢单抗可能是一个不错的选择。
