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- Presentation
What's New in Biologics and Small Molecules for Hidradenitis Suppurativa (HS)
Description
The presentation discusses recent advances in biologics and small molecules for treating Hidradenitis Suppurativa (HS), particularly focusing on drugs approved by the FDA for moderate to severe cases. The latest addition is secukinumab, an IL-17A inhibitor, which received approval last year. Other notable mentions include bimicizumab and several drugs in phase three trials, including oppadacitinib and spizolimab. The talk highlights the importance of patient-specific treatment strategies, as variations in individual patient responses complicate the decision-making process. Additionally, therapeutic drug monitoring is presented as a potential method to optimize treatment by checking drug levels and adjusting therapy based on personalized responses. The cases discussed illustrate the complexity of managing HS, showcasing various treatment responses and the need for tailored approaches, including potential combination therapies and adjusting dosing based on patient needs. The evidence indicates that finding the right therapy for each patient requires careful consideration of their specific condition and treatment history, as the field continues to evolve with new therapeutic options.
View moreConclusions
- There are now two FDA-approved drugs for hidradenitis suppurativa (HS) in the moderate to severe category.
- Secukinumab is a newly approved IL-17A inhibitor for HS, demonstrating efficacy over time.
- Therapeutic drug monitoring (TDM) can optimize treatment response and predict immunogenicity in patients using TNF-alpha inhibitors.
- Higher drug levels in patients are associated with better response rates, while anti-drug antibodies lead to reduced efficacy.
- The HLA-DQA1*05 genotype may increase the risk of immunogenicity to TNF-alpha inhibitors in HS patients.
- Initial response rates for adalimumab show approximately 50% of patients experience significant improvement, but many may not achieve complete remission.
- Weight loss, such as through GLP-1 agonists, may contribute positively to managing HS symptoms.
- Combination therapy and dose adjustments can optimize treatment effectiveness for patients who do not respond adequately to initial therapies.
- Kimball AB, et al. Lancet 2023;401:747-61.
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- Raharja et al, JID, 2023.
- Abdalla et al, 2021.
- Solitano et al. 2023. Clinical Gastroenterology and Hepatology.
- Wang LL, Micheletti RG. Low-dose methotrexate as rescue therapy in patients with hidradenitis suppurativa and pyoderma gangrenosum developing human antichimeric antibodies to infliximab: A retrospective chart review. J Am Acad Dermatol. 2020 Feb;82(2):507-510. doi: 10.1016/j.jaad.2019.09.012. Epub 2019 Sep 18.
- Sivanand A, et al. The treatment of hidradenitis suppurativa with the glucagon-like peptide-1 agonist liraglutide. Br J Dermatol. 2017 Sep;177(3):858-859. doi: 10.1111/bjd.15233. Epub 2017 Jul 14.