What's New and Hot in HS

Hidradenitis suppurativa is a life-altering diagnosis that impacts all aspects of a patient’s life from professional to psychosocial. In this presentation delivered by Joslyn Kirby, MD, the acting president of the Hidradenitis Suppurativa Foundation, emerging therapies that may change the landscape of this difficult-to-treat disease were covered along with clinical practice tips to assess treatment response. She recommended seeing patients every 4 to 6 months to assess for migratory lesions, which may indicate the need to switch treatment regimens, or persistent lesions, an indicator that procedures might be the next step. Beyond adalimumab and infliximab, secukinumab, an IL-17A inhibitor, 300 mg weekly for 5 weeks followed by a bimonthly dosing regimen, achieved 50% reduction in inflammatory lesion count by 16 weeks. Bimekizumab, which has high affinity for both IL-17A and IL-17F, also has demonstrated promising results. JAK inhibitors are another encouraging treatment path for this disease, though we still await results of ongoing clinical trials.  

Besides new biologic medications, other innovations in the field of HS include smartphone photos to harness artificial intelligence to aid in the diagnosis HS. Given the plethora of antimicrobials sometimes erroneously recommended to these patients, this technology could be useful for medical providers. Early prototypes detected moderate to severe HS with 79% sensitivity and 77% specificity. Dr Kirby also detailed up-to-date bench research on the genetics involved in HS, which may provide insight into its complex pathogenesis and potential therapeutic targets. Some things to be on the lookout for are the use of topical ruxolitinib cream and topical aryl hydrocarbon modulators for more mild disease, both of which are currently undergoing trials.