Hidradenitis suppurativa: new insights into disease mechanisms and an evolving treatment landscape

作者：James G. Krueger, John W. Frew, Gregor B. E. Jemec, Alexa B. Kimball, Brian Kirby, Falk G. Bechara, Kristina Navrazhina, Errol Prospero Prens, Kristian Reich, Eva Cullen, Kerstin Wolk · 发表于：British Journal of Dermatology · 年份：2023 · DOI：10.1093/bjd/ljad345 · 被引用次数：109 · 研究领域：Hidradenitis Suppurativa and Treatments、Colorectal and Anal Carcinomas、Anorectal Disease Treatments and Outcomes

Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic disabling and debilitating inflammatory disease with a high unmet medical need. The prevalence of HS reported in most studies is 1-2%, although it is likely to be under-reported and estimates vary globally owing to variance in data collection methods, ethnicity, geographical location and under-diagnosis. HS is characterized by persistent, painful cutaneous nodules, abscesses and draining tunnels commonly affecting the axillary, anogenital, inguinal and perianal/gluteal areas. Over time, chronic uncontrolled inflammation results in irreversible tissue destruction and scarring. Although the pathophysiology of HS has not been fully elucidated, the tumour necrosis factor (TNF)-α and interleukin (IL)-17 pathways have an important role, involving multiple cytokines. Currently, treatment options include topical medications; systemic therapies, including repeated and/or rotational courses of systemic antibiotics, retinoids and hormonal therapies; and various surgical procedures. The anti-TNF-α antibody adalimumab is currently the only biologic approved by both the US Food and Drug Administration and the European Medicines Agency for HS; however, its efficacy varies, with a clinical response reported in approximately 50% of patients in phase III trials. HS is a rapidly evolving field of discovery, with a diverse range of agents with distinct mechanisms of action currently being explored in clinical trials. Several...