Objectives: The challenges in managing Hidradenitis suppurativa(HS) and the substantial disease burden for patients and the health system have recently gained attention.
According to the VOICE project, a multinational survey among 1,299 participants, 45.9% of HS-patients are dissatisfied or very dissatisfied with care, even though they mainly received treatment according to current guidelines (mostly oral antibiotics, 85.6%).While HS was in the past mainly treated surgically in the stationary setting, it is now increasingly becoming relevant for outpatient care due to the increasing therapeutic options.
Materials / method: The literature was screened for all therapies approved for the indication of HS since the publication of the European guidelines in 2015. Moreover, all drug-option for HS currently undergoing phase-III-trials were identified from the database of clinicaltrials.gov
Results: A new device-based therapy option, combining intense pulsed light and radiofrequency, was approved for HS which shows good results in two randomized controlled trials and case reports and can be applied as long-term treatment. Clinicaltrials.gov showed that Secukinumab and Bimekizumab as well as Povorcitinib and Metformin are currently in the stage of phase-III trials. While results of the completed Bimekizumab trial are not published yet, the placebo-controlled trials on Secukinumab have recently been completed with HiSCR-response approximately 10% lower than that of Adalimumab.
Conclusion: The therapy repertoire for HS is currently subject to rapid development. Besides the expected future availability of additional biologics and small molecules, especially the device-based therapy option combining intense pulsed light and radiofrequency shows promising results mainly in the treatment of Hurley I and II. This enables doctors in outpatient care to design efficient individualized long-term treatment plans for their HS-patients.
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