Samifanni Rojina, Gatt Vincent, Kabore Jessica, Silva Mariangela, Khan Manal, Kollias Theofanis F, Clunes Lucy A
Dermatology, St. George's University School of Medicine, St. George's, GRD.
Microbiology, Immunology, and Pharmacology, St. George's University School of Medicine, St. George's, GRD.
Cureus. 2024 Nov 21;16(11):e74172. doi: 10.7759/cureus.74172. eCollection 2024 Nov.
Hidradenitis suppurativa (HS) is a painful and chronic inflammatory skin disease with no consistently effective treatment, affecting a significant portion of the Western population. HS is characterized by painful nodules, abscesses, tunnels, and scarring in body folds. The immunobiology is poorly understood, therefore resulting in a lack of effective therapies. Despite indications of microbial involvement, antimicrobial treatments have shown inconsistent and temporary results. Recent studies have identified dysregulated immune responses as a key factor in HS. This has led to the use of biologic agents, most notably adalimumab, which is currently the only FDA-approved therapy for HS. Due to the limited understanding of immune dysregulation in HS, ongoing clinical trials are adapting treatments from other skin conditions, such as psoriasis. As a result, researchers look to other skin conditions with better-understood pathophysiologies, such as psoriasis, as a starting point for developing treatments for HS. While adaptation can offer some benefits, such as immediate treatment options, the lack of specificity can lead to side effects that are not well tolerated, and long-term efficacy may be uncertain. Therefore, there is a pressing need for a foundational understanding of HS's immune dysregulation. Current ongoing research is exploring other options, such as therapies targeting IL-17, in addition to anti-TNF therapies, which have shown the potential to be more effective. With new options emerging, it is essential to evaluate the current performance of anti-TNF drugs in treating HS. This review was conducted to thoroughly assess the effectiveness of these therapies, offering a detailed analysis to inform future research and clinical practice. The objective is to determine whether anti-TNF drugs continue to be a strong treatment option or if newer therapies might lead to better outcomes for patients.
化脓性汗腺炎（HS）是一种疼痛的慢性炎症性皮肤病，目前尚无始终有效的治疗方法，影响着很大一部分西方人群。HS的特征是身体褶皱处出现疼痛性结节、脓肿、窦道和瘢痕形成。其免疫生物学机制尚不清楚，因此缺乏有效的治疗方法。尽管有迹象表明微生物参与其中，但抗菌治疗的效果并不一致且只是暂时的。最近的研究已确定免疫反应失调是HS的关键因素。这导致了生物制剂的使用，最显著的是阿达木单抗，它是目前美国食品药品监督管理局（FDA）批准的唯一用于治疗HS的药物。由于对HS中免疫失调的了解有限，正在进行的临床试验正在采用来自其他皮肤病（如银屑病）的治疗方法。因此，研究人员将病理生理学更易理解的其他皮肤病（如银屑病）作为开发HS治疗方法的起点。虽然采用其他疾病的治疗方法可能会带来一些好处，如立即有治疗选择，但缺乏特异性可能会导致难以耐受的副作用，而且长期疗效可能不确定。因此，迫切需要从根本上了解HS的免疫失调。目前正在进行的研究正在探索其他选择，如除了抗TNF疗法之外，针对IL-17的疗法，这些疗法已显示出更有效的潜力。随着新的选择不断出现，评估抗TNF药物目前在治疗HS方面的表现至关重要。本综述旨在全面评估这些疗法的有效性，提供详细分析以为未来的研究和临床实践提供参考。目的是确定抗TNF药物是否仍然是一种强有力的治疗选择，或者更新的疗法是否可能为患者带来更好的结果。
