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Can Adalimumab Improve Hematologic Abnormalities in Hidradenitis Suppurativa?

Greater improvements seen in hematologic abnormalities for patients with clinical response to adalimumab

By Dermsquared Editorial Team | May 08, 2024

WEDNESDAY, May 8, 2024 -- Adalimumab is associated with improvements in common hematologic abnormalities in patients with hidradenitis suppurativa (HS), according to a research letter published online May 8 in JAMA Dermatology.

Simon J. Gunter, from Harvard Medical School in Boston, and colleagues conducted a post-hoc analysis of the PIONEER I and II randomized clinical trials of adalimumab treatment to examine whether hematologic abnormalities improve with HS-directed therapy. Patients with moderate-to-severe HS were randomly assigned to receive 40-mg adalimumab weekly or placebo for the first 12 weeks of the study; at week 12, clinical improvement was assessed. Data were included for 594 patients with laboratory data available at baseline.

The researchers found that 42.4 percent of the patients had at least one hematologic abnormality at baseline. Of these, 68.3 percent had one hematologic abnormality; 61.1 percent had anemia. Significant improvements in hemoglobin levels, platelet count, and white blood cell count were seen in adalimumab recipients (mean, 0.37 g/dL, −34.6 x 103/µL, and −1,152.66/µL, respectively). These variables did not improve significantly in placebo recipients. Receiving adalimumab was significantly associated with the degree of improvement in these variables. Adalimumab responders had significant improvements in hemoglobin levels, platelet count, and white blood cell count; adalimumab clinical response was associated with a degree of improvement in hemoglobin levels that bordered on significance. Adalimumab responders were more likely than adalimumab nonresponders and placebo nonresponders to have a resolution of anemia.

"These findings highlight the high inflammatory load in patients with HS and the frequent occurrence of inflammation-related dyscrasias, which may warrant aggressive management," the authors write.

Several authors disclosed ties to pharmaceutical companies, including AbbVie, the manufacturer of adalimumab.


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