Kelsey R van Straalen1, Thrasyvoulos Tzellos2, Phillipe Guillem3, Farida Benhadou4, Carlos Cuenca-Barrales5, Mathilde Daxhelet4, Mathieu Daoud4, Ourania Efthymiou6, Evangelos J Giamarellos-Bourboulis7, Gregor B E Jemec8, Alexandros C Katoulis6, Anke Koenig9, Elizabeth Lazaridou10, Angelo V Marzano11, Łucas Matusiak12, Alejandro Molina-Leyva5, Chiara Moltrasio13, Andreas Pinter9, Concetta Potenza14, Jorge Romaní15, Ditte M Saunte8, Nevena Skroza14, Dimitra Stergianou7, Jacek Szepietowski12, Anastasia Trigoni10, Eva Vilarrasa16, Hessel H van der Zee17. 1. Erasmus MC, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands. 2. Department of Dermatology, Nordland Hospital Trust, Bodø, Norway. 3. Department of Surgery, Clinique du Val d'Ouest, Lyon, France; ResoVerneuil, Paris, France; Groupe de Recherche en Proctologie de la Société Nationale Française de ColoProctologie, Paris, France. 4. Department of Dermatology, Université Libre de Bruxelles, Erasme Hospital, Brussels, Belgium. 5. Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain; TECe19-Clinical and Translational Dermatology Investigation Group Instituto de Investigación Biosanitaria, Granada, Spain. 6. Second Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece. 7. Fourth Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece. 8. Department of Dermatology, Zealand University Hospital, Roskilde and Health Sciences Faculty, University of Copenhagen, Denmark. 9. Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt am Main, Germany. 10. Second Department of Dermatology and Venereology, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece. 11. Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy. 12. Department of Dermatology, Venereology and Allergology, Medical University, Wroclaw, Poland. 13. Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy. 14. Dermatology Unit 'Daniele Innocenzi,' Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino-Latina, Italy. 15. Department of Dermatology, Corporació Sanitaria Parc Taulí, Sabadell, Spain. 16. Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. 17. Erasmus MC, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands. Electronic address: h.vanderzee@erasmusmc.nl.
Abstract
BACKGROUND: Tetracyclines and clindamycin plus rifampicin combination therapy are both considered first-line therapy in current hidradenitis suppurativa guidelines. However, evidence for their efficacy is drawn from small studies, often without validated outcomes. OBJECTIVE: To assess the 12-week efficacy of oral tetracyclines and a combination of clindamycin and rifampicin. METHODS: A prospective, international cohort study performed between October 2018 and August 2019. RESULTS: In total, 63.6% of the included 283 patients received oral tetracyclines, and 36.4% were treated with clindamycin and rifampicin. Both groups showed a significant decrease in International Hidradenitis Suppurativa Severity Score System from baseline (both P < .001). The Hidradenitis Suppurativa Clinical Response (HiSCR) was achieved in 40.1% and 48.2% of patients, respectively (P = .26). Patient characteristics or disease severity were not associated with the attainment of HiSCR or the minimal clinically important differences for the Dermatology Life Quality Index and pain. LIMITATIONS: Cohort study. Respectively, 23.9% and 19.4% of patients had to be excluded from the HiSCR analysis for the tetracycline and combination therapy group because of a low abscess and nodule count at baseline. CONCLUSION: This study shows significant efficacy of both tetracycline treatment and clindamycin and rifampicin combination therapy after 12 weeks in patients with hidradenitis suppurativa. No significant differences in efficacy were observed between the 2 treatments, regardless of disease severity.
BACKGROUND:Tetracyclines and clindamycin plus rifampicin combination therapy are both considered first-line therapy in current hidradenitis suppurativa guidelines. However, evidence for their efficacy is drawn from small studies, often without validated outcomes. OBJECTIVE: To assess the 12-week efficacy of oral tetracyclines and a combination of clindamycin and rifampicin. METHODS: A prospective, international cohort study performed between October 2018 and August 2019. RESULTS: In total, 63.6% of the included 283 patients received oral tetracyclines, and 36.4% were treated with clindamycin and rifampicin. Both groups showed a significant decrease in International Hidradenitis Suppurativa Severity Score System from baseline (both P < .001). The Hidradenitis Suppurativa Clinical Response (HiSCR) was achieved in 40.1% and 48.2% of patients, respectively (P = .26). Patient characteristics or disease severity were not associated with the attainment of HiSCR or the minimal clinically important differences for the Dermatology Life Quality Index and pain. LIMITATIONS: Cohort study. Respectively, 23.9% and 19.4% of patients had to be excluded from the HiSCR analysis for the tetracycline and combination therapy group because of a low abscess and nodule count at baseline. CONCLUSION: This study shows significant efficacy of both tetracycline treatment and clindamycin and rifampicin combination therapy after 12 weeks in patients with hidradenitis suppurativa. No significant differences in efficacy were observed between the 2 treatments, regardless of disease severity.
Authors: Malgorzata Orylska-Ratynska; Waldemar Placek; Agnieszka Owczarczyk-Saczonek Journal: Int J Environ Res Public Health Date: 2022-06-13 Impact factor: 4.614