Towards the development of upgrade criteria for the treatment of hidradenitis suppurativa with biologics

作者：Georgios Nikolakis, Erkan Alpsoy, Monika Arenbergerová, Falk G. Bechara, Farida Benhadou, Joana Cabete, Raffaele Dante Caposiena, Giovanni Damiani, Maia Delage Toriel, V. del Mármol, Valentina Dini, Evangelos J. Giamarellos‐Bourboulis, K. Glasenhardt, Philippe Guillem, A. Häfner, Evgeniya Hristakieva, John R Ingram, Vaiva Jarienè, Gregor B. E. Jemec, Niamh Kearney, Brian Kirby, Natalia Kirsten, Piotr K. Krajewski, Vesta Kučinskienė, Aikaterini Ι. Liakou, Flavia Manzo Margiotta, Angelo Valerio Marzano, Antonio Martorell, Łukasz Matusiak, Dillon Mintoff, Alejandro Molina‐Leyva, Francesca Prignano, Tadas Raudonis, Hans Christian Ring, Marco Romanelli, Samed Şahin, Ditte Marie Lindhardt Saunte, Linnea Thorlacius, Thrasyvoulos Tzellos, Hessel H. van der Zee, Kelsey R. van Straalen, Christos C. Zouboulis · 发表于：Journal of the European Academy of Dermatology and Venereology · 年份：2025 · DOI：10.1111/jdv.70118 · 被引用次数：7 · 研究领域：Hidradenitis Suppurativa and Treatments、Acne and Rosacea Treatments and Effects、Dermatological and COVID-19 studies

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized primarily by dysregulated innate immunity and abnormal keratinocyte differentiation. Over the past two decades, the treatment paradigm has evolved from antibiotics to targeted biologics, such as anti-TNF-α and anti-IL-17A/A-F inhibitors. However, antibiotic therapy remains a prerequisite for biologic initiation despite a lack of comparative studies evaluating their efficacy. OBJECTIVES: This study aimed to assess current prescription patterns for systemic HS therapies among European HS specialists, evaluate unmet needs in antibiotic and biologic use and explore expert opinions on criteria for biologic upgrade as a first-line therapy. METHODS: A structured questionnaire was distributed to 55 HS specialists, the majority of whom were members of the European Hidradenitis Suppurativa Foundation (EHSF), comprising HS experts and future opinion leaders. Responses underwent statistical analysis to assess trends in antibiotic versus biologic prescription, treatment efficacy and potential improvements in therapeutic decision-making. RESULTS: A total of 43 participants (76.6% of invited experts, 80% of invited opinion leaders) responded. While 95% adhered to licensing regulations mandating 10-12 weeks of antibiotics before biologics, 81% acknowledged prescribing antibiotics despite anticipating inadequate responses. More than half reported patient-reported flares during antibiotic treatment. ...