54091 Biologic efficacy and reasons for discontinuation in a tertiary referral hidradenitis suppurativa clinic
Recommended Citation
Young A, Lu K, Dai A, Kagithala D, Samir E, Gregory M, Romanski M, Dimitrion P, Hamzavi I, Mi Q. 54091 Biologic efficacy and reasons for discontinuation in a tertiary referral hidradenitis suppurativa clinic. J Am Acad Dermatol 2024; 91(3):AB25.
Document Type
Conference Proceeding
Publication Date
9-1-2024
Publication Title
J Am Acad Dermatol
Abstract
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition often unresponsive to conventional treatments. Biologic therapies targeting TNFα (first-line) and IL-17/IL-23 (second-line) have gained prominence for managing resistant cases. However, a comprehensive understanding of their real-world efficacy and underlying causes for treatment discontinuation remains limited. Methods: Leveraging a patient cohort from a specialized HS clinic, this study conducted an exhaustive examination of medical records from initial dermatological consultation to the latest follow-up, ending on September 4, 2023. Results: Among 391 patients, 178 (46%) had taken 1 or more biologics: adalimumab (N=147; 38%), infliximab (N=111; 28%), ustekinumab (N=22; 5.6%), secukinumab (N=19; 4.9%), and guselkumab (N=12; 3.1%). For those completing ≥3 months with assessable data, discontinuation rates at 1 year due to inefficacy were: adalimumab (47/93; 51%), infliximab (5/59; 8.5%), ustekinumab (9/17; 53%), secukinumab (7/8; 88%), and guselkumab (5/7; 71%). Infection led to discontinuation in 4.1%, 1.8%, 9.1%, 0%, and 0%, respectively. Side effect(s) other than infection led to discontinuation in 7.5%, 13%, 14%, 16%, and 8.3%, respectively. Lack of insurance coverage led to discontinuation in 4.8%, 5.4%, 4.5%, 0%, and 25%, respectively. Other reasons encompassed loss to follow-up, surgery, cancer diagnosis, switching to another medication due to comorbidity, latent tuberculosis, COVID-19 concerns, neutralizing anti-drug antibodies, needle anxiety, and clinical trial participation. Conclusion: This dataset reveals insights into biologic efficacy and common reasons for discontinuation in HS management. Infliximab discontinuation rates were the lowest among the TNF-alpha inhibitors. Rates of discontinuation of second-line therapies are high, emphasizing the urgent need to develop effective treatments for refractory HS.
Volume
91
Issue
3
First Page
AB25
