Effectiveness of Secukinumab in Refractory Hidradenitis Suppurativa: A Real-World Study: Descriptive Research Dirençli Hidradenitis Süpürativa’da Secukinumab’ın Etkinliği: Gerçek Yaşam Deneyimi: Tanımlayıcı Araştırma

Abstract

Objective: Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory skin disease characterized by nodules, abscesses, and sinus tracts, often associated with systemic inflammation and significant comorbidities. Although tumor necrosis factor-α (TNF-α) inhibitors such as adalimumab have been used in treatment, many patients experience inadequate responses. Secukinumab, an interleukin-17A inhibitor, has recently been approved for moderate-to-severe HS. However, real-world data on its effectiveness and impact on inflammatory biomarkers remain limited. Material and Methods: This retrospective descriptive study included 8 patients with refractory HS who received secukinumab at a single tertiary center between 2022-2024. Demographic and clinical data, including International Hidradenitis Suppurativa Severity Score System (IHS4) scores and C-reactive protein (CRP) levels, were recorded before and after treatment. Secukinumab was administered at 300 mg weekly for 5 weeks, followed by 300 mg every 4 weeks. Treatment response was assessed using Hidradenitis Suppurativa Clinical Response 50 (HiSCR50) and changes in IHS4 scores. CRP levels were analyzed using the Wilcoxon signed-rank test. Results: The median age of patients was 46 years, and the median disease duration was 17.5 years. Six patients had prior anti-TNF-α treatment failure. Seven patients (87.5%) showed a reduction in CRP levels, and all patients demonstrated improvement in IHS4 scores. HiSCR50 was achieved in 7 of 8 patients (87.5%). The median IHS4 score significantly decreased from 8.5 to 4.5 (p=0.0078). One patient developed pneumonia during treatment, possibly related to immunosuppression or comorbid chronic kidney disease. No other serious adverse events were reported. Conclusion: Secukinumab may be a promising and well-tolerated treatment option for patients with HS, including refractory to anti-TNF-α agents and other conventional treatments.