Gargiulo Luigi, Ibba Luciano, Narcisi Alessandra, Giordano Silvia, Maronese Carlo A, Martora Fabrizio, Repetto Federica, Paolino Giovanni, Balato Anna, Burlando Martina, Dapavo Paolo, Dini Valentina, Guarneri Claudio, Marzano Angelo V, Megna Matteo, Mercuri Santo R, Costanzo Antonio, Valenti Mario
Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Dermatol Pract Concept. 2024 Oct 30;14(4):e2024250. doi: 10.5826/dpc.1404a250.
Psoriasis and hidradenitis suppurativa (HS) are chronic inflammatory diseases with significant overlap in their immunologic pathways, which involve cytokines such as tumor necrosis factor-alfa, interleukin (IL)-17, and IL-23. Current treatment options for HS are limited, as only adalimumab and secukinumab are approved for severe cases. Given the overlapping pathogenetic features between HS and psoriasis, anti-IL-17 and anti-IL-23 drugs could represent valuable treatments for the management of HS.
We sought to evaluate the effectiveness and safety of anti-IL-17 and anti-IL-23 drugs in patients with HS and concomitant moderate-to-severe plaque psoriasis.
We conducted a multicenter retrospective study in 11 Italian Dermatology Units. The effectiveness of the drugs was evaluated by assessing the percentage of patients achieving HS Clinical Response (HiSCR) each week.
We enrolled 41 patients with at least 16 weeks of follow-up, with 17 of them completing 52 weeks of treatment. The most commonly prescribed anti-IL drug was secukinumab (27 patients), followed by ixekizumab (5) and guselkumab (5). The HiSCR was achieved by 39%, 74.3%, and 77.8% of patients after 16, 32, and 52 weeks, respectively. No severe adverse events (AEs) or AEs leading to discontinuation were observed during the study. The most common AE was nasopharyngitis (four patients).
In this real-world study, we highlight the effectiveness of anti-IL-23 and anti-IL-17 drugs in the treatment of concomitant plaque psoriasis and severe HS. Longer and larger studies are needed to further evaluate the long-term effectiveness and safety of these treatments in patients affected by HS.
银屑病和化脓性汗腺炎（HS）是慢性炎症性疾病，其免疫途径有显著重叠，涉及肿瘤坏死因子-α、白细胞介素（IL）-17和IL-23等细胞因子。目前HS的治疗选择有限，因为只有阿达木单抗和司库奇尤单抗被批准用于重症病例。鉴于HS和银屑病之间重叠的发病机制特征，抗IL-17和抗IL-23药物可能是治疗HS的有价值的药物。
我们试图评估抗IL-17和抗IL-23药物治疗HS合并中度至重度斑块状银屑病患者的有效性和安全性。
我们在11个意大利皮肤科单位进行了一项多中心回顾性研究。通过评估每周达到HS临床缓解（HiSCR）的患者百分比来评估药物的有效性。
我们纳入了41例至少随访16周的患者，其中17例完成了52周的治疗。最常用的抗IL药物是司库奇尤单抗（27例患者），其次是依奇珠单抗（5例）和古塞库单抗（5例）。分别有39%、74.3%和77.8%的患者在16周、32周和52周后达到HiSCR。在研究期间未观察到严重不良事件（AE）或导致停药的AE。最常见的AE是鼻咽炎（4例患者）。
在这项真实世界研究中，我们强调了抗IL-23和抗IL-17药物治疗合并斑块状银屑病和重度HS的有效性。需要进行更长时间和更大规模的研究，以进一步评估这些治疗方法对HS患者的长期有效性和安全性。
