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Ricardo Blanco, MD; Víctor M. Martínez-Taboada, MD; Ignacio Villa, MD; M. Carmen González-Vela, MD; Héctor Fernández-Llaca, MD; Mario Agudo, MD; Marcos A. González-López, MD

Arch Dermatol. 2009;145(5):580-584.

Background  Several studies report the use of tumor necrosis factor (TNF-) inhibitors in refractory hidradenitis suppurativa (HS), particularly infliximab and etanercept. However, very limited data have been reported for adalimumab, the newest fully human anti–TNF- monoclonal antibody. We evaluated the long-term efficacy and safety of adalimumab therapy in 6 patients with refractory HS. In the case of positive culture findings from any draining lesion, antibiotic therapy was administered for at least 2 weeks before initiating adalimumab therapy. Adalimumab (in 40-mg subcutaneous injections) was prescribed every other week. If the disease was inadequately controlled, the dosage was increased to 40 mg/wk. If HS was in persistent clinical remission, adalimumab therapy was gradually decreased to 40 mg every 3 weeks. Quality of life was assessed using the Dermatology Life Quality Index.

Observations  Six patients (mean [SD] age, 39.3 [12.9] years) with severe HS (mean [SD] duration, 22.5 [11.7] years) were treated with adalimumab. Significant improvements after 1 month of treatment were seen in the Dermatology Life Quality Index; in the number of affected regions, nodules, and fistulas; and in the basic laboratory findings. Improvements were maintained for a mean (SD) follow-up of 21.5 (7.1) (range, 13-29) months. Adalimumab was well tolerated.

Conclusion  Adalimumab appears to be an effective and safe treatment for refractory HS.

Author Affiliations: Departments of Rheumatology (Drs Blanco, Martínez-Taboada, Villa, and Agudo), Pathology (Dr González-Vela), and Dermatology (Drs Fernández-Llaca and González-López), Marqués de Valdecilla University Hospital Medical Faculty, University of Cantabria, Santander, Spain.

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