Interesting Open Access Hidradenitis Suppurativa (HS) Reads – November 2024
Some interesting open access #HidradenitisSuppurativa (HS)-related publications that appeared last month (November 2024) in PubMed.
Australasian Hidradenitis Suppurativa Management Guidelines
Using a modified Delphi process, thirteen clinical experts developed these timely HS treatment management guidelines and treatment algorithms to direct appropriate clinical management in the Australasian context. Overall management strategies include appropriate disease severity assessment, comorbidity screening, multimodal therapy with systemic and local treatments, and therapeutic ladders in the event of inadequate response. The guidelines also feature situations meriting specific considerations, such as comorbidities, pregnancy, and breastfeeding.
Link: https://onlinelibrary.wiley.com/doi/10.1111/ajd.14388
Citation: Frew J, Smith A, Penas PF, Ellis E, Foley P, Rubel D, McMeniman E, Marshman G, Saunders H, Veysey E, Nicolopolous J, Spelman L, Gebauer K. Australasian hidradenitis suppurativa management guidelines. Australas J Dermatol. 2024 Nov 22. doi: 10.1111/ajd.14388. Epub ahead of print. PMID: 39578415.
Increased Risk of Migraine in Patients with HS
As HS and migraine share common inflammatory pathways and neuropsychological implications, the authors of this study aimed to evaluate possible relationships between HS and incident migraine. Using data from people diagnosed with HS in multiple centres over almost 20 years and comparing with people unaffected by HS, the authors report a 1.3-fold increased risk of incident migraine in patients with HS, especially in females. The authors also report that the risk of migraine remained increased in younger and older subgroups and in people with psychiatric comorbidities.
Link: https://www.sciencedirect.com/science/article/pii/S2319417024001197?via%3Dihub
Citation: Gau SY, Lo SW, Chiu TM, Li CP, Tsai RY, Chang HC, Chi CC. Increased risk of migraine among patients with hidradenitis suppurativa: A US multi-center cohort study. Biomed J. 2024 Nov 18:100816. doi: 10.1016/j.bj.2024.100816. Epub ahead of print. PMID: 39566658.
Factors Affecting HS Diagnostic Delay
The delay in diagnosing HS has been widely reported and the authors of this study investigated the factors behind this diagnostic delay from a healthcare system equity perspective. Using clinical and demographic data from a cross-sectional survey of dermatologists and their consulting patients in France, Germany, Italy, Spain, the UK, and the USA, the authors identified numerous factors contributing to this diagnostic delay, including demographics, disease-related, patient-related, and health system-related. The analyses identify potential targets to speed up diagnosis and improve outcomes for people with HS.
Link: https://link.springer.com/article/10.1007/s13555-024-01291-0
Citation: Murray N, Truman I, Milligan G, Modi H, Adlard N. Equity and Outcome Events in Hidradenitis Suppurativa: Exploring Effect Modifiers Associated with Diagnostic Delay in the Real World. Dermatol Ther (Heidelb). 2024 Dec;14(12):3211-3227. doi: 10.1007/s13555-024-01291-0. Epub 2024 Nov 2. PMID:39487935.
Key Insights into HS Treatment Success and Failure
Three key opinion leaders in HS offer their insights on some results from some recent clinical trials and cellular and molecular studies, which have impacted understanding of HS disease pathogenesis and offer key insights into HS treatment successes and failures. This viewpoint focuses on B cells as drivers of inflammation, the prominent role of fibroblasts, and possible bacterial triggers. Furthermore,
Link: https://www.jci.org/articles/view/186744
Citation: van Straalen KR, Piguet V, Gudjonsson JE. Hidradenitis suppurativa: key
insights into treatment success and failure. J Clin Invest. 2024 Nov
1;134(21):e186744. doi: 10.1172/JCI186744. PMID: 39484718
Diagnostic Wandering in HS
‘Diagnostic wandering’ refers to the process in which a patient undergoes multiple tests, consultations, or referrals without reaching a definitive diagnosis. A team from France comprising people with HS and clinicians aimed to assess diagnostic wandering in patients with HS and identify associated factors in France using a questionnaire developed by the team and approved by the French Society of Dermatology’s Task Force HS group. Their analysis identified numerous factors associated with diagnostic wandering, including gender, income, and education levels and helps focus future awareness and education efforts.
Link: https://onlinelibrary.wiley.com/doi/10.1111/jdv.20425
Citation: Fite C, Taieb C, Nassif A, Delage-Toriel M, Cassius C, Skayem C, Le Floc’h C, Kerob D, Benhayoun Y, Bru MF, Marion M, Demessant AL, Joubert JM, Caillet G, Halioua B, Zimmermann C, Pommaret E, Nicol I, Cogrel O, Richard MA. Diagnostic wandering in hidradenitis suppurativa: A nationwide cohort study. J Eur Acad Dermatol Venereol. 2024 Nov 10. doi: 10.1111/jdv.20425. Epub ahead of print. PMID: 39523774.
Treatment Satisfaction Survey of Patients with HS
This cross-sectional market research survey involving 1787 patients with HS from 312 dermatologists across France, Germany, Italy, Spain, UK, and USA used physician- and patient-reported surveys to assess treatment patterns and patient- and physician-reported satisfaction with disease control. Notable levels of dissatisfaction from both dermatologists and patients were reported. Furthermore, the data suggest a high disease burden and potential undertreatment in patients with HS.
Link: https://karger.com/drm/article/doi/10.1159/000542343/915549/Treatment-satisfaction-in-patients-with
Citation: Ingram JR, Bettoli V, Espy JI, Kokolakis G, Martorell A, Villani AP, Wallinger H, Truman I, Coak E, Kasparek T, Muscianisi E, Richardson C, Kimball AB. Treatment satisfaction in patients with hidradenitis suppurativa: A real-world survey from the EU5 and US. Dermatology. 2024 Nov 5:1-22. doi: 10.1159/000542343. Epub ahead of print. PMID: 39500291.
Systematic Review and Meta-Analysis of HS Excision Wound Closures Techniques
Wide surgical excision is often used in HS management strategies and recommended by many of the international HS treatment guidelines. The authors of this systematic review and meta-analysis evaluated the most efficient wound closure methods following wide excision of HS lesions focusing on recurrence, functionality, and quality of life.
Link: https://onlinelibrary.wiley.com/doi/10.1111/ijd.17553
Citation: Cucu CI, Ciobotariu I, Paradisi A, Di Nardo L, Fossati B, Mannino M, Malvaso D, Chiricozzi A, Peris K. Wound closure techniques after wide excision for hidradenitis suppurativa: a systematic review and meta-analysis. Int J Dermatol. 2024 Nov 14. doi: 10.1111/ijd.17553. Epub ahead of print. PMID: 39540220.
Long-Term Efficacy and Safety of Secukinumab in Patients with Moderate-to-Severe HS
The SUNRISE and SUNSHINE core trials formed the basis of the approval of secukinumab in patients with moderate-to-severe HS in many major markets in 2023. This extension trial study sought to evaluate the long-term efficacy, safety/tolerability, and maintenance of clinical response of secukinumab. Patients with a HS clinical response (HiSCR) at Week 52 of the core trials (entered a randomized withdrawal period. The primary endpoint was time to loss of response through Week 104 in Week 52 HiSCR responders. Analysis revealed that the primary endpoint was not met but that response as measured using HiSCR was maintained in many patients. The safety of secukinumab was consistent with the previously characterised safety profile in the core trials.
Link: https://academic.oup.com/bjd/advance-article/doi/10.1093/bjd/ljae469/7913451
Citation: Kimball AB, Bechara FG, Badat A, Giamarellos-Bourboulis EJ, Gottlieb AB, Jemec GBE, Reguiai Z, Villani AP, Alarcon I, Bansal A, Gasperoni F, Martin R, Paguet B, Uhlmann L, Zouater H, Ravichandran S, Alavi A. Long-term efficacy and safety of secukinumab in patients with moderate-to-severe hidradenitis suppurativa: Week 104 results from the SUNSHINE and SUNRISE extension trial. Br J Dermatol. 2024 Nov 29:ljae469. doi: 10.1093/bjd/ljae469. Epub ahead of print. PMID: 39611771.
Artificial Intelligence-Generated Information for Patients with HS
In this report, researchers investigated the accuracy of artificial intelligence (AI) chatbots, ChatGPT, and Bard in providing information for patients about HS. Patient-relevant questions were formulated with the help of HS patient associations, and the AI-generated responses to these questions were then evaluated by HS clinical experts. The findings highlight the potential of AI chatbots, particularly ChatGPT, in supporting patients but also emphasises shortcomings in AI-driven medical advice, especially regarding treatment options.
Citation: Ezanno AC, Fougerousse AC, Pruvost-Balland C, Maccari F, Fite C; ResoVerneuil. AI in Hidradenitis Suppurativa: Expert Evaluation of Patient-Facing Information. Clin Cosmet Investig Dermatol. 2024 Nov 2;17:2459-2464. doi: 10.2147/CCID.S478309. PMID: 39507766.
Roles of IL-17A and IL-17F in HS Pathogenesis
Recently, a new treatment options targeting the cytokines IL17A and IL17F, has been approved for use in HS. This timely study sought to further investigate the roles of IL-17A and IL-17F in HS pathogenesis. RNA sequencing was used to identify differentially expressed genes in skin biopsies taken at baseline and after treatment at Week 12 with the il17A/F inhibitor bimekizumab in patients with moderate to severe HS. Analysis revealed that treatment resulted in reduced expression of upregulated genes within HS lesions, included those associated with neutrophil biology. The authors conclude that the data support the hypothesis that IL-17A and IL-17F play central roles in HS.
Link: https://academic.oup.com/bjd/advance-article/doi/10.1093/bjd/ljae442/7896334
Citation: Rastrick J, Edwards H, Ferecskó AS, Le Friec G, Manghera A, Page M, Shaw S. The roles of IL-17A and IL-17F in hidradenitis suppurativa pathogenesis: evidence from human in vitro preclinical experiments and clinical samples. Br J Dermatol. 2024 Nov 12:ljae442. doi: 10.1093/bjd/ljae442. Epub ahead of print. PMID: 39531733.
