Department of Medical Sciences, Section of Dermatology, University of Turin, Turin, Italy.
Exp Dermatol. 2024 Jul;33(7):e15140. doi: 10.1111/exd.15140.
Real-world data on the long-term effectiveness of the anti-IL17 agent secukinumab in treating moderate-to-severe Hidradenitis suppurativa (HS) are lacking. In this study, 24 patients with moderate-severe HS received five weekly subcutaneous injections followed by maintenance doses every 4 weeks. Primary outcomes included HiSCR, IHS4 reduction, and DLQI measures assessed at 12-week intervals. The median secukinumab drug survival was 16.0 months (range 3-51), with a 56.5% maximal response rate at 6 months and dropout exceeding 40% at 1 year. Baseline disease burden emerged as a key predictor of treatment response, overshadowing factors like sex or BMI. Prior systemic steroid use negatively impacts drug survival. The study underscores the critical 6-month window for assessing treatment efficacy, emphasizing the importance of initial induction dosing. Additionally, the newly developed scoring system, IHS4-55, showed analogies to the older HiSCR score in capturing treatment response. In this real-life scenario, challenges persist in HS management, necessitating innovative therapeutic approaches and predictive markers.
有关抗白细胞介素 17 药物司库奇尤单抗治疗中重度化脓性汗腺炎（HS）长期疗效的真实世界数据尚缺乏。在这项研究中，24 例中重度 HS 患者接受了 5 周的每周一次皮下注射，然后每 4 周维持一次剂量。主要终点包括每 12 周评估的 HiSCR、IHS4 减少和 DLQI 指标。司库奇尤单抗的中位药物无失败生存期为 16.0 个月（范围 3-51），6 个月时最大应答率为 56.5%，1 年时失访率超过 40%。基线疾病负担是治疗反应的关键预测因素，超过了性别或 BMI 等因素。既往全身使用皮质类固醇会对药物无失败生存产生负面影响。该研究强调了评估治疗效果的关键 6 个月窗口，突出了初始诱导剂量的重要性。此外，新开发的 IHS4-55 评分系统与较旧的 HiSCR 评分在捕捉治疗反应方面具有相似性。在这种真实环境下，HS 管理仍面临挑战，需要创新的治疗方法和预测标志物。
