Christos C Zouboulis1,2, Hendrik Hansen3, Raffaele Dante Caposiena Caro4,5, Giovanni Damiani4,6, Isabelle Delorme7, José Carlos Pascual4,8, Ziad Reguiai4,9, Anastasia Trigoni4,10, Eva Vilarrasa4,11, Fernando Alfageme Roldán12. 1. Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany, christos.zouboulis@mhb-fontane.de. 2. European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany, christos.zouboulis@mhb-fontane.de. 3. Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany. 4. European Hidradenitis Suppurativa Foundation e.V., Dessau, Germany. 5. Department of Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy. 6. Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 7. Dr. Isabelle Delorme Inc., Drummondville, Québec, Canada. 8. Department of Dermatology, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain. 9. Department of Dermatology, Reims University Hospital, University of Champagne-Ardenne, Reims, France. 10. Second Department of Dermatology and Venereology, General Hospital Papageorgiou, Aristotle University of Thessaloniki, Thessaloniki, Greece. 11. Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. 12. Department of Dermatology, University Hospital Puerta De Hierro Majadahonda, Madrid, Spain.
Abstract
BACKGROUND: Adalimumab is the only approved compound for the treatment of adult patients with moderate-to-severe hidradenitis suppurativa (HS) who did not respond to a systemic classical treatment. Despite its significant short- and long-term efficacy, a percentage of patients do not respond sufficiently. Moreover, some primary responders experience a response loss with time. OBJECTIVE: To analyse the effectiveness of adalimumab dose intensification in HS patients. METHODS: A case series of adalimumab 80 mg/week subcutaneously (s.c.) compassionate use in patients with HS, who did not respond sufficiently or in primary responders with progressive response loss to the registered adalimumab dose of 40 mg/week s.c. Patients were collected and evaluated retrospectively. Patients' data were extracted from medical records. RESULTS: The 14 patients collected were Caucasian with HS of Hurley stage II-III and moderate or severe International HS Severity Score System (IHS4) stage. Adalimumab dose intensification significantly improved IHS4 score, Pain Index, HS-Physician Global Assessment, pain, and Cardiff Dermatology Life Quality Index. Two young female patients with HS and Crohn's disease developed psoriatic lesions during the treatment with adalimumab 80 mg/week s.c. CONCLUSION: An enhanced level of effectiveness was assessed in the majority of the HS patients treated with adalimumab dose intensification (80 mg/week s.c.). Larger studies are required to evaluate this observation.
BACKGROUND: Adalimumab is the only approved compound for the treatment of adult patients with moderate-to-severe hidradenitis suppurativa (HS) who did not respond to a systemic classical treatment. Despite its significant short- and long-term efficacy, a percentage of patients do not respond sufficiently. Moreover, some primary responders experience a response loss with time. OBJECTIVE: To analyse the effectiveness of adalimumab dose intensification in HSpatients. METHODS: A case series of adalimumab 80 mg/week subcutaneously (s.c.) compassionate use in patients with HS, who did not respond sufficiently or in primary responders with progressive response loss to the registered adalimumab dose of 40 mg/week s.c. Patients were collected and evaluated retrospectively. Patients' data were extracted from medical records. RESULTS: The 14 patients collected were Caucasian with HS of Hurley stage II-III and moderate or severe International HS Severity Score System (IHS4) stage. Adalimumab dose intensification significantly improved IHS4 score, Pain Index, HS-Physician Global Assessment, pain, and Cardiff Dermatology Life Quality Index. Two young female patients with HS and Crohn's disease developed psoriatic lesions during the treatment with adalimumab 80 mg/week s.c. CONCLUSION: An enhanced level of effectiveness was assessed in the majority of the HSpatients treated with adalimumab dose intensification (80 mg/week s.c.). Larger studies are required to evaluate this observation.
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