Efficacy and safety of bimekizumab in patients with moderate-to-severe hidradenitis suppurativa (BE HEARD I and BE HEARD II): two 48-week, randomised, double-blind, placebo-controlled, multicentre phase 3 trials

The Lancet, Journal Year: 2024, Volume and Issue: 403(10443), P. 2504 - 2519

Published: May 22, 2024

Language: Английский

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Biologics for Hidradenitis suppurativa: evolution of the treatment paradigm

Expert Review of Clinical Immunology, Journal Year: 2023, Volume and Issue: 20(5), P. 525 - 545

Published: Dec. 22, 2023

Introduction Hidradenitis suppurativa (HS) is an autoinflammatory skin disease with a high unmet need for effective medical management. Clinically, it characterized by inflammatory nodules that may progress into abscesses, draining tunnels and extensive scarring, mainly affecting apocrine gland-bearing areas.

Language: Английский

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The role of interleukin‐36 in health and disease states

Journal of the European Academy of Dermatology and Venereology, Journal Year: 2024, Volume and Issue: 38(10), P. 1910 - 1925

Published: May 23, 2024

Abstract The interleukin (IL)‐1 superfamily upregulates immune responses and maintains homeostasis between the innate adaptive systems. Within IL‐1 superfamily, IL‐36 plays a pivotal role in both responses. Of four isoforms, three have agonist activity (IL‐36α, IL‐36β, IL‐36γ) fourth has antagonist (IL‐36 receptor [IL‐36Ra]). All isoforms bind to (IL‐36R). Binding of IL‐36α/β/γ IL‐36R recruits accessory protein (IL‐1RAcP) activates downstream signalling pathways mediated by nuclear transcription factor kappa B mitogen‐activated kinase pathways. Antagonist binding IL‐36Ra inhibits recruitment IL‐1RAcP, blocking Changes balance within cytokine family can lead uncontrolled inflammatory throughout body. As such, been implicated numerous diseases, notably type pustular psoriasis called generalized (GPP), chronic, rare, potentially life‐threatening, multisystemic skin disease characterised recurrent fever extensive sterile pustules. In GPP, is central pathogenesis, prevention IL‐36‐mediated improve clinical outcomes. this review, we summarize literature describing biological functions pathway. We also consider evidence for activation pathway wide range (e.g., plaque psoriasis, hidradenitis suppurativa, acne, Netherton syndrome, atopic dermatitis pyoderma gangrenosum), lung idiopathic pulmonary fibrosis), gut intestinal fibrosis, bowel Hirschsprung's disease), kidney renal tubulointerstitial lesions) infectious diseases caused variety pathogens COVID‐19; Mycobacterium tuberculosis , Pseudomonas aeruginosa Streptococcus pneumoniae infections), as well cancer. how targeting could be used treating states.

Language: Английский

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Hidradenitis Suppurativa: An Understanding of Genetic Factors and Treatment

Biomedicines, Journal Year: 2024, Volume and Issue: 12(2), P. 338 - 338

Published: Feb. 1, 2024

Hidradenitis suppurativa (HS), recognized as a chronic and debilitating skin disease, presents significant challenges in both diagnosis treatment. This review explores the clinical manifestations, genetic landscape, molecular mechanisms underlying HS. The disease’s association with predisposing background, obesity, smoking, occlusion underscores complexity of its etiology. Genetic heterogeneity manifests sporadic, familial, syndromic forms, focus on mutations γ-secretase complex genes, particularly NCSTN. dysregulation immune mediators, including TNF-α, IL-17, IL-1β, IL-12/23, plays crucial role inflammatory nature Recent advancements research have identified potential therapeutic targets, leading to development anti-TNF-α, anti-IL-17, anti-IL-1α, anti-IL-12/23 therapies JAK inhibitors. These interventions offer promise alleviating symptoms improving quality life for HS patients.

Language: Английский

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S2k-Leitlinie zur Therapie der Hidradenitis suppurativa/Acne inversa (ICD-10-Code: L73.2)

Aktuelle Dermatologie, Journal Year: 2024, Volume and Issue: 50(01/02), P. 30 - 83

Published: Feb. 1, 2024

Zusammenfassung Ziel der S2k-Leitlinie zur Therapie Hidradenitis suppurativa/Acne inversa (HS/AI) ist es, eine akzeptierte Entscheidungshilfe für die Auswahl sowie Durchführung einer geeigneten/suffizienten von Patienten mit HS/AI zu liefern. chronisch rezidivierende, entzündliche, potenziell mutilierende Hauterkrankung des terminalen Haartalgdrüsenapparats, sich schmerzhaften, entzündlichen Läsionen in den apokrinen drüsenreichen Körperregionen manifestiert, insbesondere axillären Inguinal- und Anogenitalregion. Die intensive klinische experimentelle Forschung Überprüfung neuer therapeutischen Ansätze haben seit Veröffentlichung alten Leitlinie im Jahr 2012 Kenntnisse auf dem Gebiet bedeutend verbessert. In Deutschland wurde Punktprävalenz aktiven Erkrankung 0,3 % beobachtet, sie stieg unter Berücksichtigung HS/AI-typischen Narben aber nicht aktiver 3,0 %. Säulen HS/AI-Pathogenese sind abnormale Differenzierung Keratinozyten Haartalgdrüsenapparats massive begleitende Entzündung. primären entzündliche Knoten, Abszesse drainierende Tunnel, überwiegend an Prädilektionsstellen (axillär, submammär, inguinal, genital perineal). Rezidive letzten 6 Monaten mindestens 2 verweisen HS/AI. Obwohl anhand dieser Kriterien Diagnosestellung hohen Genauigkeit 97 erfolgen kann, noch wenig bekannt, wie Verspätung Diagnose 10,0 ± 9,6 Jahren beweist. leiden deutlichen Einschränkung Lebensqualität, bei hohem Morbiditätsgrad. soll täglichen Praxis einem validierten Instrument klassifiziert ihre Aktivität bewertet werden, v. a. International Suppurativa Severity Scoring System (IHS4), um korrekte Therapieentscheidungen treffen können. wird Formen Zusammenhang Ausprägung stets nachweisbaren Entzündung eingeteilt, nämlich vorwiegend Formen. Während Intensität Form mithilfe IHS4-Klassifikation milde, mittelschwere schwere eingeteilt entsprechend medikamentös behandelt wird, über chirurgische Behandlung nach Hurley-Grad befallenen Lokalisation, I, II III entschieden. Orale Tetrazykline oder 5-tägige intravenöse Clindamycin Effektivität oralen systemischen Kombination Rifampicin gleich gestellt. subkutan applizierbaren monoklonalen Antikörper Adalimumab Secukinumab zugelassen. Für stehen verschiedene operative Verfahren Verfügung. medikamentösen Reduktion operativen Verfahren, Beseitigung irreversiblen Gewebeschadens, gilt aktuell als ganzheitliches Therapieverfahren Eine regelmäßige Kontrolle ggf. Anpassung Hinblick einen ändernden Krankheitsschweregrad empfohlen.

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Efficacy and Safety of Biologics and Small Molecules for Moderate-to-Severe Hidradenitis Suppurativa: A Systematic Review and Network Meta-Analysis

Pharmaceutics, Journal Year: 2023, Volume and Issue: 15(5), P. 1351 - 1351

Published: April 28, 2023

Background: Treatment of hidradenitis suppurativa (HS) is difficult and current guidelines are based mainly on expert opinion non-randomized controlled trials. Recently, there have been some targeted therapies using uniform primary endpoints for outcome assessment. Objective: Recommendations can be provided selecting biologics synthetic small molecules refractory HS by comparing the efficacy safety these medications. Methods: Databases including ClinicalTrial.gov, Cochrane Library, PubMed were searched. Randomized trials (RCTs) moderate-to-severe eligible. We performed random-effect network meta-analysis ranking probability. The was Hidradenitis Suppurativa Clinical Response (HiSCR) at 12-16 weeks. Secondary included Dermatology Life Quality Index (DLQI) 0/1, mean change DLQI from baseline, adverse effects. Results: A total 12 RCTs involving 2915 patients identified. Adalimumab, bimekizumab, secukinumab 300 mg q4w q2w showed superiority to placebo in HiSCR weeks 16. In addition, no significant difference between bimekizumab adalimumab as measured (RR = 1.00; 95% CI: 0.66-1.52) 0/1 2.40, 0.88-6.50). terms probability achieving weeks, ranked first, followed q4w, q2w. All did not differ development effects compared placebo. Conclusions: represent four regimens that produce better outcomes than without increased risk events. Adalimumab exhibited best 12-16.

Language: Английский

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A Patient With Concurrent Hidradenitis Suppurativa and Porokeratosis Palmaris et Plantaris Disseminata: Case Report and Review of Autoinflammatory Keratinization Diseases

Journal of Cutaneous Pathology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 3, 2025

ABSTRACT The term autoinflammatory keratinization diseases (AIKDs) was recently proposed as a unifying concept for characterized by inflammation in the epidermis and upper dermis which leads to hyperkeratosis, caused genetic perturbations of innate immune system. We present case patient with hidradenitis suppurativa porokeratosis, two AIKDs, followed review these conditions well other AIKDs. This distinguished hypertrophic porokeratoses involving cystic hair follicles, showing histopathologic features both within single biopsy specimens. patient's course additionally complicated SCC arising porokeratosis. Our demonstrates rare overlap occurring not only same but also lesions.

Language: Английский

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Hidradenitis suppurativa, from basic science to surgery and a new era of tailored targeted therapy: An expert opinion paper

Archives of Dermatological Research, Journal Year: 2025, Volume and Issue: 317(1)

Published: Feb. 28, 2025

Abstract Hidradenitis suppurativa (HS) is a chronic inflammatory disease characterised by an aberrant activation of innate immunity and increased production pro-inflammatory mediators such as interleukin 17 (IL-17). IL-17 has been shown to play key role in the pathogenesis HS evidence highlights potential IL-17-targeted therapies. The fully human IgG/κ monoclonal antibody secukinumab, which specifically targets IL-17A inhibits interaction with its receptor, recently approved for treatment moderate-to-severe HS. Secukinumab offers patients efficacious well-tolerated option terms sustained response rapidly improving signs symptoms, preventing progression absence loss response. Being challenging disease, associated delay diagnosis 3–10 years and, consequently, late implementation appropriate treatment, leading progression. Misdiagnosis due flawed understanding lack awareness among medical providers considered important factor contributing delayed diagnosis. Thus, serious efforts must be made on large scale urgently reduce burden patients, including raising awareness, education programmes at specialisation schools, well continuous healthcare different levels early detection initiation treatment. Here, we present main critical unmet needs affected HS, address how comprehensive multidisciplinary management (offering both surgical care) can benefit suggest therapeutic options, based clinical characterisation identification intervention (window opportunity), adopted timely better fill current gaps.

Language: Английский

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Endotyping Insulin–Glucose Homeostasis in Hidradenitis Suppurativa: The Impact of Diabetes Mellitus and Inflammation

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(7), P. 2145 - 2145

Published: March 21, 2025

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease often associated with metabolic disorders such as diabetes mellitus. Recent research suggests link between systemic inflammation and insulin-glucose dysregulation in HS. This study investigates the relationship homeostasis, mellitus haptoglobin concentration HS patients. Methods: We assessed 95 patients 49 controls using validated fasting-based function tests, including Structural Parameter Inference Approach (SPINA), Homeostasis Model Assessment (HOMA) Quantitative Insulin Sensitivity Check Index (QUICKI). Results: The had significantly higher fasting insulin (97.2 vs. 69.0 pmol/L, p = 0.035), increased resistance (HOMA-IR: 3.47 2.57, 0.016) impaired sensitivity (SPINA-GR: 1.34 1.76 mol/s, 0.017). In diabetes, was more strongly reduced 0.61 1.41 0.0057) 7.3 3.2, Higher concentrations were accompanied by worse glycaemic control, demonstrating elevated glucose (5.77 5.11 mmol/L, 0.043) HbA1c (5.7% 5.4%, 0.0081) fraction. Conclusions: Our findings suggest that contributes to dysregulation, worsening particularly those or diabetes.

Language: Английский

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Successful Treatment of PAPASH Syndrome With Concomitant FMF Using IL‐1 Blockade: A Case Report

International Journal of Dermatology, Journal Year: 2025, Volume and Issue: unknown

Published: April 17, 2025

Language: Английский

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