Caudrelier Nicolas, Veillette Hélène
Division of Dermatology, Department of Medicine, CHU de Québec-Université Laval, Québec, QC, Canada.
J Cutan Med Surg. 2025 May-Jun;29(3):250-253. doi: 10.1177/12034754241308248. Epub 2025 Jan 7.
Adalimumab is a central treatment for moderate-to-severe hidradenitis suppurativa (HS). However, half of patients treated with adalimumab for HS do not achieve a clinically significant response. Data on non-immunological factors correlating clinical response and adalimumab blood concentration are scarce.
To determine whether increasing adalimumab dose to 80 mg weekly can improve the clinical outcome of patients unresponsive to adalimumab 40 mg weekly. To identify parameters influencing disease activity and those modifying serum adalimumab concentration.
This is a retrospective case series from a tertiary dermatology clinic, comprising 40 patients with moderate-to-severe HS with suboptimal response to the FDA-approved dose of adalimumab. All patients had a measurement of blood adalimumab concentration. Depending on their dosage, some patients had their adalimumab dose increased to 80 mg weekly while others stayed at 40 mg dose weekly. Chi-squared and ANOVA tests were used for data analysis.
43.8% of patients who increased to a weekly dose of 80 mg clinically improved at their follow-up, compared with 33.3% of those who stayed at a weekly dose of 40 mg. The dose increase led to a statistically significant increase in serum concentration of adalimumab ( < .001). Higher serum adalimumab concentration is associated with lower disease activity ( = .043). Normal-weight patients had significantly higher concentrations than overweight patients ( = .011).
An increase in the weekly dose of adalimumab led to a nonstatistically significant improvement in clinical response but led to a statistically significant increase in serum concentration.
阿达木单抗是中重度化脓性汗腺炎（HS）的主要治疗药物。然而，接受阿达木单抗治疗的HS患者中有一半未达到临床显著反应。关于与临床反应和阿达木单抗血药浓度相关的非免疫因素的数据很少。
确定将阿达木单抗剂量增加至每周80mg是否能改善对每周40mg阿达木单抗无反应的患者的临床结局。确定影响疾病活动的参数以及改变血清阿达木单抗浓度的参数。
这是一项来自三级皮肤科诊所的回顾性病例系列研究，包括40例对美国食品药品监督管理局（FDA）批准剂量的阿达木单抗反应欠佳的中重度HS患者。所有患者均检测了血阿达木单抗浓度。根据剂量不同，部分患者将阿达木单抗剂量增加至每周80mg，而其他患者维持在每周40mg的剂量。采用卡方检验和方差分析进行数据分析。
增加至每周80mg剂量的患者中，43.8%在随访时临床症状改善，而维持在每周40mg剂量的患者中这一比例为33.3%。剂量增加导致阿达木单抗血清浓度有统计学显著升高（P<0.001）。较高的血清阿达木单抗浓度与较低的疾病活动度相关（P = 0.043）。体重正常的患者浓度显著高于超重患者（P = 0.011）。
阿达木单抗每周剂量增加导致临床反应有非统计学显著改善，但血清浓度有统计学显著升高。
