Objectives: Understand the main features of the disease, the challenges with the treatments and how to choose between antibiotics and biotherapies.
Introduction: As HS is both an infectious and auto-inflammatory disease, treatments can be both antibiotics and anti-cytokines antibodies, mainly anti-TNF-alpha. Surgery is also an important option which will be discussed in another session.
Materials / method: Review of the literature ans experience of RESOVERNEUIL in France (french network for HS).
Results: The main protocol is the association of rifampicin / clindamycin. Many protocols have derived now from this historical one: rifampicin / ofloxacin; rifampicin / moxifloxacin / metronidazole in induction phase, and then cotrimoxazole in maintenance phase. For biologics, the anti-TNF adalumimab in the only one to have an agreement in Europe. But many new molecules are under investigation: anti-IL-17 (secukinumab), anti-IL-23 (guselkumab), anti-complement fractions (anti-C5a). The field of treatments is now increasing every year.
Conclusion: The best option depends on the main clinical presentation: purulent or rather inflammatory phase. In a same patient, treatment can change depending on a particular phase of the disease. It remains anyway a multidisciplinary approach.
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