Pinto Salgueiro Gonçalo, Yilmaz Orhan, Nogueira Miguel, Torres Tiago
Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal.
College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
BioDrugs. 2025 Jan;39(1):53-74. doi: 10.1007/s40259-024-00687-w. Epub 2024 Nov 28.
Hidradenitis suppurativa (HS) is a chronic, debilitating, inflammatory dermatosis that significantly impacts patients' quality of life, primarily manifesting as inflammatory nodules, abscesses, and tunnels. The pathogenesis of HS is not fully understood and appears to be multifactorial, involving genetic, immunological, and endocrinological factors, as well as dysbiosis of skin microbiota. Increasing evidence highlights the role of the interleukin (IL)-17 pathway in the inflammatory process and pathogenesis of HS. Consequently, IL-17 inhibitors have emerged as a promising alternative to current therapies. Recently, secukinumab received approval from both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA), while bimekizumab received approval from the EMA, for the treatment of moderate-to-severe HS in adults, with ongoing clinical trials aiming to further clarify the efficacy and safety of other drugs within this class. IL-17 inhibitors have shown effectiveness in treating moderate-to-severe HS, with safety profiles of drugs such as secukinumab and bimekizumab being comparable to their use in other dermatological conditions. On the other hand, innovative drugs such as sonelokimab and izokibep show promising results and are currently in phase III clinical trials. This review provides a comprehensive overview of current knowledge and scientific advances in HS, focusing on the IL-17 pathway's role and its inhibition as a treatment strategy, alongside examining the most recent and significant clinical studies on various IL-17 inhibitors in the treatment of HS.
化脓性汗腺炎(HS)是一种慢性、使人衰弱的炎症性皮肤病,对患者的生活质量有重大影响,主要表现为炎性结节、脓肿和窦道。HS的发病机制尚未完全明确,似乎是多因素的,涉及遗传、免疫和内分泌因素,以及皮肤微生物群失调。越来越多的证据凸显了白细胞介素(IL)-17通路在HS炎症过程和发病机制中的作用。因此,IL-17抑制剂已成为现有疗法的一种有前景的替代方案。最近,司库奇尤单抗获得了美国食品药品监督管理局(FDA)和欧洲药品管理局(EMA)的批准,而比美吉珠单抗获得了EMA的批准,用于治疗成人中重度HS,目前正在进行临床试验,旨在进一步阐明该类其他药物的疗效和安全性。IL-17抑制剂已显示出治疗中重度HS的有效性,司库奇尤单抗和比美吉珠单抗等药物的安全性与它们在其他皮肤病中的使用情况相当。另一方面,索内洛单抗和伊佐基贝等创新药物显示出有前景的结果,目前正处于III期临床试验阶段。本综述全面概述了HS的当前知识和科学进展,重点关注IL-17通路的作用及其作为一种治疗策略的抑制作用,同时审视了关于各种IL-17抑制剂治疗HS的最新和重要临床研究。