How effective are TNF-alpha inhibitors in the treatment of hidradenitis suppurativa (HS)?

Updated: Aug 30, 2019
  • Author: Marina Jovanovic, MD, PhD; Chief Editor: William D James, MD  more...
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Answer

Other TNF-alpha inhibitors, including etanercept (a human fusion protein receptor consisting of 2 human TNF-alpha receptors and Fc domain of human immunoglobulin G1) and adalimumab (a fully humanized recombinant anti-TNF-alpha monoclonal antibody), have also been studied. For etanercept, not enough information is available to assess the true risks of TNF-alpha inhibitor use as therapy for hidradenitis suppurativa. Thus, randomized controlled studies are necessary to determine the risk-to-benefit ratio of TNF-alpha inhibitor therapy in the treatment of hidradenitis suppurativa. [117, 118, 119, 120, 121] In 2015, the FDA approved adalimumab to treat moderate-to-severe hidradenitis suppurativa in adults showing inadequate response to conventional therapy. The indication was expanded in 2018 to include adolescents aged 12 years or older. Approval for adolescents was supported by evidence from adequate and well-controlled studies in adults. Additional population pharmacokinetic modeling and simulation predicted that weight-based dosing was generally similar to adults. Adalimumab is recommended as a first-line treatment option in patients with moderate-to-severe hidradenitis suppurativa who are unresponsive to or intolerant of oral antibiotics. [102]


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