33431 Efficacy of 80 mg/week dose of adalimumab (Humira) in treatment of hidradenitis suppurativa

Abstract

Hidradenitis suppurativa (HS) is an inflammatory skin condition involving the apocrine gland-bearing regions, such as the axillae, groin, anogenital, and inframammary areas. Though its etiology is unknown, disease manifests when hair follicles become obstructed, leading to the release of inflammatory mediators, such as TNF-α and IL-17. Levels of TNF-α have been found to be elevated in lesions of HS, providing a basis for the use of biologics in treatment of severe HS. Adalimumab is a recombinant human IgG1 anti-TNF monoclonal antibody which acts via antagonism of TNF-α. Although adalimumab has been studied in phase 2 and 3 trials and has been approved as a treatment modality for HS at a 40 mg weekly dose, numerous patients still suffer on a day-to-day basis due to the severity of their disease and do not respond to this conventional dosing. We present a series of 6 such patients whose response to an 80 mg/week dose of adalimumab has been positive, with a decrease in severity and number of HS lesions, leading to improvement in the Hidradenitis Suppurativa Clinical Response (HiSCR) in the absence of serious adverse effects. Although this dosing regimen has not been well-documented in literature, it is important to consider the lasting benefits of treatment with a higher dose in individuals afflicted with treatment-resistant HS, including a decreased likelihood of comorbidities and complications and an improved quality of life.