Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Adalimumab Therapy in 18 Patients with Severe Hidradenitis Suppurativa.
Fernandez5, Orlando Pompei, Alonso5, Ricardo Blanco, Villa4, Ignacio, Lopez2, Marcos Gonzalez, LLaca1, Hector Fernández, Gonzalez-Vela3, M. Del Carmen, Bilbao6, Mario Agudo
Department of Dermatology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria
Department of Inmunology, Hospital de Liencres, Santander, Cantabria
Department of Pathology, Hospital Universitario Marqués de Valdecilla
Department of Rheumatology, Hospital Sierrallana
Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria
Department of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
Several case-reports describing successful response to TNF-a antagonists in patients with hidradenitis suppurativa (HS), especially with infliximab and etanercept, have been reported. However, most of them had a short follow-up, showed limited efficacy and/or unacceptable side effects. Our aim was to evaluate the efficacy and safety of adalimumab therapy in 18 patients with refractory HS.
All of them fulfilled the following criteria: (1) HS resistant to standard medical treatments; (2) lack of response to at least 1 systemic immunomodulating drug; (3) multifocal active HS. In all cases Adalimumab therapy (40 mg subcutaneously every-other-week) was started. If HS was not adequately controlled, adalimumab dosage was increased up to 40 mg/week. If persistent clinical remission was achieved adalimumab therapy was gradually decreased to a minimum dose of 40 mg every 3 weeks. Quality of life was assessed using the Dermatology Life Quality Index (DLQI).
18 patients (9W:9M) (mean age, 45.17±15.8 years) with severe HS (mean disease duration, 19.83 ± 17.3 years) were studied. In 6 patients HS was associated with other conditions; SLE (2 cases), rheumatoid arthritis (2 cases), idiopathic monoarthritis (1 case), and psoriasis (1 case). Five patients had initially been treated with infliximab and 1 with etanercept. All these 5 patients were switched to adalimumab due to inefficacy. At 1st month 13, 4 and 1 patient achieved high, moderate and none improvement in suppurative symptoms, respectively. The 6 patients with associated diseases also experienced improvement of these conditions. After a mean follow-up of 92 ± 88 weeks adalimumab efficacy was maintained. Adalimumab was well-tolerated. The most frequent side-effect was mild to moderate pain at injection site, and only 1 patient developed a severe facial skin reaction.
Adalimumab seems to be an effective and safe treatment in refractory HS. These promising results warrant the need of prospective controlled study.
To cite this abstract, please use the following information:
Fernandez, Orlando Pompei, Alonso, Ricardo Blanco, Villa, Ignacio, Lopez, Marcos Gonzalez, LLaca, Hector Fernández, Gonzalez-Vela, M. Del Carmen, et al; Adalimumab Therapy in 18 Patients with Severe Hidradenitis Suppurativa. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1650