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- Presentation
Guidance Around Management of HS with Targeted Therapies in the Context of Comorbidities
Description
The presentation discusses the management of Hidradenitis Suppurativa (HS) patients, emphasizing the importance of targeted therapies despite the presence of comorbidities such as infections, malignancies, and inflammatory bowel disease (IBD). The speaker highlights the need to control inflammation in HS patients, acknowledging their vulnerability and complex treatment landscape. Despite concerns about comorbidities, the speaker argues for the necessity of effective treatments, comparing the risk-benefit analysis in HS to that in other chronic conditions. Key topics include managing hepatitis B reactivation risks through appropriate screening and prophylaxis, addressing potential COVID-19 severity in HS patients treated with biologics, and evaluating cancer risks associated with different therapies. The use of TNF inhibitors may be less advisable for patients with a history of lymphoma, while other cytokine inhibitors present lower risks. The discussion also outlines the baseline risk of IBD in HS patients, asserting that while there may be increased incidences observed in clinical trials, the real-world implications are minimal, particularly for those without family history of IBD. Overall, the presentation calls for a collaborative approach among healthcare professionals to optimize HS management and patient outcomes.
View moreConclusions
- The primary goal in managing hidradenitis suppurativa (HS) is to control inflammation and alleviate symptoms, even when addressing comorbidities.
- Patients with HS often have multiple comorbidities that require consideration in treatment plans.
- It is essential to assess a patient's baseline risks and select appropriate treatments to mitigate potential adverse outcomes.
- Biologic therapies are generally safe and effective for HS, even in the presence of conditions like hepatitis B, with proper management and monitoring.
- The risk of hepatitis B reactivation can be minimized with prophylactic antiviral therapy and careful drug selection. TNF inhibitors pose a higher risk compared to other biologics.
- HS patients do not have an increased risk of severe COVID-19 illness compared to the general population, even when treated with biologics.
- Patients with HS should be screened for latent tuberculosis (TB) before initiating biologic therapy due to the risk of reactivation.
- Individuals with HS have a higher baseline risk for malignancies, but overall risks remain low with appropriate selection of therapies.
- Caution should be exercised with TNF inhibitors in patients with a history of lymphoma; other classes of biologics may be preferred.
- Inflammatory bowel disease (IBD) is more prevalent among HS patients, and treatment should be approached cautiously, avoiding IL-17 inhibitors in individuals with a known diagnosis of IBD.
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