53351 Predictors of drug survival in patients with hidradenitis suppurativa treated with TNF-alpha-inhibitors

Authors

Albert Young, Henry Ford HealthFollow
Kathy Lu, Henry Ford HealthFollow
Andrea Dai, Henry Ford HealthFollow
Dheeraj Kagithala, Henry Ford HealthFollow
Eglal Samir, Henry Ford HealthFollow
Mark Gregory, Henry Ford Health
Madison Romanski, Henry Ford HealthFollow
Peter Dimitrion, Henry Ford HealthFollow
Iltefat Hamzavi, Henry Ford HealthFollow
Qing-Sheng Mi, Henry Ford HealthFollow

Recommended Citation

Young A, Lu K, Dai A, Kagithala D, Samir E, Gregory M, Romanski M, Dimitrion P, Hamzavi I, Mi Q. 53351 Predictors of drug survival in patients with hidradenitis suppurativa treated with TNF-alpha-inhibitors. J Am Acad Dermatol 2024; 91(3):AB72.

Document Type

Conference Proceeding

Publication Date

9-1-2024

Publication Title

J Am Acad Dermatol

Abstract

Background: Adalimumab and infliximab are biologics commonly used to treat hidradenitis suppurativa (HS). Factors underlying heterogeneity in treatment response are poorly understood. Methods: Patients from a tertiary HS referral clinic who had taken adalimumab or infliximab for at least 90 days were included. Multivariate Cox proportional-hazards models were fitted with drug survival as a function of age, sex, race, family history, age of onset, smoking status, body mass index (BMI), Hurley stage, anatomic sites affected, and previous biologic use. Results: 135 patients were included; the median age was 40 (range 19-67), 72% were female, and 45% were Black. 117 patients took adalimumab for a median of 304 days (IQR 153, 458); by 1 year, 66% had stopped due to inefficacy. Younger age (HR 1.03 [1.002-1.06] per year), BMI 30-40 (HR 2.26 [1.18-4.27]), BMI 40+ (HR 2.46 [1.22-4.96]), Hurley stage III disease, compared to stage II (HR 3.91 [1.83-8.35]), and groin involvement (HR 3.87 [1.47-10.18]) were significantly associated with adalimumab failure. Eighty-four patients took infliximab for a median of 464 days (IQR 299, 878); by 1 year, 22% had stopped due to inefficacy. No variables were significantly associated with infliximab failure. Conclusion: Infliximab had higher drug survival than adalimumab. Patients with younger age, obesity, Hurley Stage III disease, and groin involvement were more likely to fail adalimumab. No statistically significant predictors of infliximab response were identified, despite this being the largest reported cohort to date, suggesting a need for more nuanced data (e.g., biomarkers or genetic data) and/or larger sample size.

Volume

91

Issue

3

First Page

AB72