Turkiye Klinikleri J Dermatol. 2025;35(3):82-8 82 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 Güllü GENCEBAYa, Nisan ÇETİN YETİMOVAa, Didem DİZMANa, Özlem Su KÜÇÜKa aBezmiâlem Vakıf University Faculty of Medicine, Department of Dermatology, İstanbul, Türkiye This study was presented as a poster at the 32th National Dermatology Congress, November 20-24, 2024, Antalya, Türkiye (PS037). ABS TRACT Objective: Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory skin disease characterized by nodules, ab- scesses, 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 pa- tients 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 inflam- matory biomarkers remain limited. Material and Methods: This ret- rospective 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 pro- tein (CRP) levels, were recorded before and after treatment. Secuk- inumab 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 me- dian disease duration was 17.5 years. Six patients had prior anti-TNF-α treatment failure. Seven patients (87.5%) showed a reduction in CRP lev- els, and all patients demonstrated improvement in IHS4 scores. HiSCR50 was achieved in 7 of 8 patients (87.5%). The median IHS4 score signifi- cantly decreased from 8.5 to 4.5 (p=0.0078). One patient developed pneu- monia during treatment, possibly related to immunosuppression or comorbid chronic kidney disease. No other serious adverse events were re- ported. Conclusion: Secukinumab may be a promising and well-toler- ated treatment option for patients with HS, including refractory to anti-TNF-α agents and other conventional treatments. Keywords: Secukinumab; hidradenitis suppurativa; interleukin-17 ÖZET Amaç: Hidradenitis süpürativa (HS), nodüller, apseler ve sinüs traktları ile seyreden, sistemik inflamasyon ve önemli komorbiditelerle ilişkili, kronik, tekrarlayıcı inflamatuar bir deri hastalığıdır. Tedavide adalimumab gibi tümör nekroz faktörü-α (TNF-α) inhibitörleri kulla- nılmakla birlikte birçok hastada tedaviye yetersiz yanıt görülmektedir. İnterlökin-17A inhibitörü olan secukinumab, yakın zamanda orta-şid- detli HS tedavisi için onay almıştır. Ancak bu ilacın etkinliği ve infla- matuar biyobelirteçler üzerindeki etkisine dair gerçek yaşam verileri sınırlıdır. Gereç ve Yöntemler: Bu retrospektif tanımlayıcı çalışmaya, 2022-2024 yılları arasında tek bir 3. basamak merkezde secukinumab tedavisi alan, dirençli HS tanılı 8 hasta dâhil edildi. Hastaların demo- grafik ve klinik verileri ile birlikte tedavi öncesi ve sonrası “Interna- tional Hidradenitis Suppurativa Severity Score System (IHS4)” skorları ve C-reaktif protein (CRP) düzeyleri kaydedildi. Secukinumab, ilk 5 hafta boyunca haftalık 300 mg dozunda, ardından her 4 haftada 1 300 mg idame dozu şeklinde uygulandı. Tedavi yanıtı, “Hidradenitis Sup- purativa Clinical Response 50 (HiSCR50)” ve IHS4 skorlarındaki de- ğişim ile değerlendirildi. CRP düzeyleri Wilcoxon işaretli sıra testi kullanılarak analiz edildi. Bulgular: Hastaların medyan yaşı 46 yıl, hastalık süresi ise 17,5 yıl idi. Altı hastada daha önce anti-TNF-α tedavi başarısızlığı mevcuttu. Yedi hasta (%87,5) CRP düzeylerinde azalma gösterdi ve tüm hastalarda IHS4 skorlarında iyileşme saptandı. Sekiz hastanın 7’sinde (%87,5) HiSCR50 yanıtı elde edildi. Medyan IHS4 skoru, 8,5’ten 4,5’e anlamlı şekilde azaldı (p=0,0078). Bir hastada te- davi sırasında muhtemelen immünosupresyon veya eşlik eden kronik böbrek hastalığına bağlı olarak pnömoni gelişti. Başka ciddi advers olay bildirilmedi. Sonuç: Secukinumab, anti-TNF-α tedavisine ve diğer kon- vansiyonel tedavilere dirençli HS hastalarında, umut vadeden ve iyi to- lere edilen bir tedavi seçeneği olabilir. Anah tar Ke li me ler: Secukinumab; hidradenitis süpürativa; interlökin-17 DOI: 10.5336/dermato.2024-107937 Correspondence: Güllü GENCEBAY Bezmiâlem Vakıf University Faculty of Medicine, Department of Dermatology, İstanbul, Türkiye E-mail: gullugencebay5@gmail.com Peer review under responsibility of Turkiye Klinikleri Journal of Dermatology. Re ce i ved: 27 Dec 2024 Received in revised form: 16 Aug 2025 Ac cep ted: 30 Sep 2025 Available online: 27 Oct 2025 2146-9016 / Copyright © 2025 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Türkiye Klinikleri Dermatoloji Dergisi Turkiye Klinikleri Journal of Dermatology ORIGINAL RESEARCH ORİJİNAL ARAŞTIRMA TO CITE THIS ARTICLE: Gencebay G, Çetin Yetimova N, Dizman D, Küçük ÖS. Effectiveness of secukinumab in refractory hidradenitis suppurativa: A real-world study: Descriptive research. Turkiye Klinikleri J Dermatol. 2025;35(3):82-8. https://orcid.org/0000-0002-1195-4200 https://orcid.org/0009-0008-5011-8484 https://orcid.org/0000-0002-0745-270X https://orcid.org/0000-0002-1140-9261 https://creativecommons.org/licenses/by-nc-nd/4.0/ Hidradenitis suppurativa (HS) is a chronic in- flammatory disorder marked by the formation of draining nodules, abscesses, fistulae, sinus tracts, and scarring in areas such as the axillae, inguinal folds, and anogenital areas, which notably contain apocrine glands. Typically emerging around puberty, HS has a higher incidence in females compared to males. While the precise etiology remains unclear, risk fac- tors such as obesity, smoking, and a genetic predis- position to acne have been recognized. The disease is also frequently associated with comorbid condi- tions, including dyslipidemia, hyperglycemia, hyper- tension, myocardial infarction, cerebrovascular events, psoriasis, depression, anxiety. The manage- ment of HS is challenging due to the complexity of the lesions and their high recurrence rate, which ad- versely affects patients’ psychological well-being and significantly impairs quality of life.1 As knowledge of immune dysregulation in HS improves, more biologic drugs and targeted therapies are being studied as potential treatments. These ther- apies act on various immune pathways by targeting molecules such as tumor necrosis factor (TNF), in- terleukin-17A (IL-17), IL-12, IL-23, IL-1, Janus ki- nases, tyrosine kinase 2, and chemokine receptors like CXCR1 and CXCR2. Adalimumab, a TNF-α in- hibitor, was the first biologic approved for the man- agement of moderate-to-severe HS. More recently, secukinumab -a human monoclonal antibody target- ing IL-17A- received approval from both the U.S. Food and Drug Administration (FDA) and the Euro- pean Medicines Agency in October 2023 for the treatment of adults with active, moderate-to-severe HS. Bimekizumab, another IL-17 inhibitor, was ap- proved for the treatment of HS in the European Union in April 2024, followed by U.S. FDA approval in November 2024.2 In clinical trials on HS, disease severity is typically assessed using lesion-based scor- ing systems that consider abscesses, inflammatory nodules, and draining fistulas. Commonly used scor- ing systems include Hurley staging, the modified Sar- torius score, Hidradenitis Suppurativa Physician’s Global Assessment, Hidradenitis Suppurativa Clini- cal Response (HiSCR), and the International Hidradenitis Suppurativa Severity Score System (IHS4). Among these, HiSCR50 is the most fre- quently used primary endpoint. Understanding these scoring systems is essential for interpreting clinical trial outcomes and for guiding treatment decisions in clinical practice.2 In this study, we aimed to report 8 patients with HS who demonstrated a favorable clinical response to secukinumab following inadequate response to anti- TNF-alpha inhibitor treatment and other conventional treatments. MATERIAL AND METHODS This study was conducted as a retrospective descrip- tive analysis of 8 patients with HS who received se- cukinumab treatment at Bezmiâlem Vakıf University Faculty of Medicine, Department of Dermatology be- tween 2022-2024. Baseline characteristics recorded for all patients included age, sex, disease duration, age at HS onset, Hurley stage before treatment, IHS4 scores before and after treatment, comorbidities, and prior therapies (as summarized in Table 1). All com- prehensive laboratory tests -including complete blood count, serologic tests for human immunode- ficiency virus (HIV), hepatitis B and C, and the QuantiFERON-TB Gold test (Qiagen, German- town, MD, USA)- were obtained from the hospi- tal’s electronic laboratory records. Additionally, C-reactive protein (CRP) levels were recorded be- fore and after secukinumab treatment (Table 2). Clinical response, adverse events, and relevant lab- oratory parameters documented at each follow-up visit were systematically evaluated. Secukinumab was administered at a dosage of 300 mg once weekly during the initial month (on days 0, 7, 14, 21, and 28), followed by a maintenance dose every 4 weeks thereafter. HS severity was as- sessed using the IHS4, and treatment response was evaluated based on changes from baseline (Table 1). HiSCR50 was used as the primary endpoint. HiSCR50 was defined as a ≥50% reduction in the total number of inflammatory nodules, with no in- crease in the number of abscesses or draining fistulas compared to baseline. CRP and IHS4 values before and after treatment were compared using the Wilcoxon signed-rank test, given the limited sample size and non-normal data Güllü GENCEBAY et al. Turkiye Klinikleri J Dermatol. 2025;35(3):82-8 83 Güllü GENCEBAY et al. Turkiye Klinikleri J Dermatol. 2025;35(3):82-8 84 distribution. For all analyses, statistical significance was set at p=0.05. ETHICAL APPROvAL This study was conducted in accordance with the principles of the Declaration of Helsinki. The Ethics Committee of the Bezmiâlem Vakıf University ap- proved the study with an approved number of April 1, 2024-146737. The patients in this manuscript have given written informed consent to the publication of their case details. RESULTS We evaluated 8 patients, aged between 21-66 years, with a median age of 46 years. The disease duration ranged from 2 to 18 years, with a median duration of 17.5 years. A detailed summary of patient character- istics is provided in Table 1. Of these, 7 patients had moderate to severe HS classified as Hurley stage II or III, while one patient had mild HS, categorized as Hurley stage I. Six of the 8 patients had previously received at least one biologic agent (adalimumab or infliximab) but demonstrated an inadequate clinical response. One patient with Hurley stage I disease who was refractory to systemic antibiotic therapy (Patient 5) was ineligible for anti-TNF treatment due to contraindications, including congestive heart fail- ure and a history of ischemic stroke. Therefore, off- label secukinumab therapy was initiated. In another patient (Patient 7), secukinumab was selected as the first-line biologic therapy due to the presence of con- comitant moderate-to-severe plaque psoriasis. Sero- logic tests for HIV, hepatitis B, and hepatitis C, as well as the QuantiFERON-TB Gold test, were all negative. Smoking was the most frequent comorbid- ity, affecting 62.5% of the cohort, followed by dia- TABLE 1: Baseline characteristics of all patients HS: Hidradenitis suppurativa; IHS4: International Hidradenitis Suppurativa Severity Score System; M: Male Patient Age (years)/sex Age at onset of HS (years) Duration of disease (years) Hurley stage before treatment Duration of therapy (months) IHS4 before treatment IHS4 after treatment Comorbidities Previous medications 1 35/M 20 15 3 12 12 2 Smoking+Pilonidal sinus Acne conglobata Adalimumab 2 66/M 52 14 3 24 25 12 Smoking-Pilonidal sinus Diabetes mellitus Umbilical hernia Adalimumab 3 42/M 22 20 3 9 10 5 Smoking+Diabetes mellitus Hypertension Adalimumab Infliximab 4 50/M 39 11 3 2 7 5 Smoking+Diabetes mellitus Hypertension Chronic kidney failure Adalimumab 5 60/M 58 2 1 19 3 1 Smoking-Congestive heart failure Ischemic stroke injury Doxycycline 6 55/M 37 18 3 12 25 13 Smoking+Diabetes mellitus Adalimumab 7 22/M 14 7 2 5 6 1 Smoking+Psoriasis vulgaris Methotrexate 8 21/M 13 8 2 10 6 4 Smoking-Pilonidal sinus Acne conglobata Adalimumab CRP before CRP after Patient Age (years)/sex treatment treatment 1 35/M 5.14 3.90 2 66/M 53.73 24.99 3 42/M 62.62 20.92 4 50/M 9.90 18.9 5 60/M 5.66 2.41 6 55/M 120.48 53 7 22/M 5.66 2.20 8 21/M 31 8,41 TABLE 2: Laboratory test CRP of all patients CRP: C-reactive protein; M: Male Güllü GENCEBAY et al. Turkiye Klinikleri J Dermatol. 2025;35(3):82-8 85 betes in 50%, pilonidal sinus disease in 37.5%, and acne conglobata in 25% of patients. One patient re- quired a reconstructive surgical intervention during the treatment period. Seven patients (87.5%) exhib- ited a reduction in CRP levels (patients 1, 2, 3, 5, 6, 7, and 8), as shown in Table 2 and Figure 1. One pa- tient developed pneumonia 2 months into secuk- inumab therapy and required hospitalization; this individual had chronic renal failure as a comorbidity. CRP levels did not decrease in this case, likely due to the pneumonia. The median CRP level decreased from 20.45 mg/L at baseline to 13.66 mg/L after treatment; however, this reduction was not statisti- cally significant (p=0.0547). The duration of secuk- inumab treatment and the corresponding changes in IHS4 scores for each patient are presented in Table 1. Notably, all patients (100%) demonstrated improve- ment in IHS4 scores compared to baseline, and 87.5% (7 out of 8) achieved the HiSCR50 response following secukinumab treatment. In one patient (Pa- tient 1), HiSCR50 was not achieved due to an in- crease in inflammatory nodules, despite a reduction in sinus tract formation. The median IHS4 score showed a significant decrease from 8.5 to 4.5, re- flecting a notable clinical improvement (p=0.0078). No serious adverse events were observed, except for a case of pneumonia in 1 patient. DISCUSSION HS is a chronic inflammatory dermatological condi- tion affecting areas in apocrine glands, primarily the axillae, inguinal, and anogenital regions. The disease is now recognized as an inflammatory process from the hair follicle, though its exact pathogenesis re- mains only partially understood. Elevated levels of IL-1β and tumor necrosis factor-alpha (TNF-α) have been identified in affected skin, indicating a role for the innate immune system.3 Additionally, upregulated expression of IL-12, IL-17, and IL-23 has been re- ported in HS lesions.4 Recent studies have demon- strated a marked increase in IL-17-expressing cells in both lesional and perilesional skin of patients with HS, suggesting a potential role in the initiation and amplification of inflammatory pathways.5 Neu- trophils have been identified as the predominant source of IL-17 in HS, whereas CD4⁺ T cells [T helper 17 (Th17) cells] were present in substantially lower numbers. These findings suggest that although CD4⁺ T cells contribute to IL-17 production, neu- trophils may play a more prominent role, further sup- porting the involvement of the IL-17 pathway in HS pathogenesis. Consistent with the aforementioned study, Matusiak et al. reported significantly elevated serum IL-17 levels in HS patients compared to FIGURE 1: Comparison of C-reactive protein (CRP) levels before and after secukinumab treatment. Güllü GENCEBAY et al. Turkiye Klinikleri J Dermatol. 2025;35(3):82-8 86 healthy controls.6 These findings emphasize the im- portance of IL-17 in the pathogenesis of HS and high- light the need for clinical studies evaluating anti-IL-17 therapies. Accordingly, secukinumab be- came the first IL-17A inhibitor approved by FDA in October 2023 for the treatment of adults with mod- erate-to-severe HS. Recent clinical trials, including the SUNSHINE (n=541) and SUNRISE (n=543) studies, have provided valuable insights into the effi- cacy and safety profile of secukinumab. Patients with moderate-to-severe HS were randomized to receive secukinumab 300 mg every 2 weeks, every 4 weeks, or a placebo. In the SUNSHINE trial, the group re- ceiving secukinumab every 2 weeks achieved a sig- nificantly higher clinical response (81.5 patients or 45% of 181) compared to the placebo group (60.7 pa- tients or 34% of 180), with an odds ratio of 1.8 (p=0.0070). Conversely, no significant difference was observed between the secukinumab every-4- weeks group (75.2 patients or 42% of 180) and the placebo (57.1 patients or 31% of 183; p=0.042). The SUNRISE trial demonstrated significant clinical im- provements for both the biweekly (76.2 patients or 42%) and the monthly (83.1 patients or 46%; p=0.0022) secukinumab groups compared to the placebo (57.1 patients or 31%).7 Similarly, in our study, all patients treated with 300 mg monthly se- cukinumab showed a reduction in IHS4 scores, and 87.5% achieved a HiSCR50 response. Several recent case series, case reports, and ret- rospective studies have reported promising real-world data regarding the efficacy of secukinumab. In a 52- week real-world study, Martora et al. reported that among 21 HS patients who failed adalimumab, 71.4% achieved HiSCR response. Significant im- provements in IHS4, Dermatology Life Quality Index (DLQI), and visual analog scale pain scales were recorded at both weeks 16 and 52.8 An open label trial of 20 patients with moderate-to-severe HS, including 6 with prior anti-TNF-α therapy, showed that 70% (n=14) achieved HiSCR by week 24. Notably, 5 of the 6 patients previously treated with anti-TNF-α agents also reached HiSCR at the same time point. Although DLQI scores improved by 4±6 points at week 12, no significant improvement was observed at week 24.9 A multicenter Italian retrospective study in 31 patients with moderate-to-severe HS reported a re- duction in IHS4 scores and a HiSCR response rate of 41% at week 28. These findings are lower than those reported in other studies.10 In another study focusing on drug survival, 24 patients with moderate-to-severe HS were treated with secukinumab, initially admin- istered weekly for 5 weeks and then every 4 weeks as maintenance. The median drug survival was 16 months, with a peak response rate of 56.5% at 6 months and a dropout rate exceeding 40% at 1 year. The study highlights the importance of the induction phase and suggests that 6 months is a critical point for evaluating treatment efficacy.11 In our study, the longest duration of secukinumab treatment was 24 months in 1 patient (Patient 2). Additionally, 4 out of 8 patients (50%) continued treatment for more than 12 months. Comorbidities are prevalent among HS patients, contributing to the overall disease burden. A Spanish cohort study identified pilonidal sinus disease in 32.6% (269 of 839) of patients, which correlated with an earlier HS onset, higher Hurley stage, inflamma- tory phenotype, and increased fistulae and perianal involvement.12 Additionally, a Turkish cross-sec- tional study reported significantly higher smoking rates among HS patients than in controls.13 In our co- hort, smoking (62.5%) was the most common co- morbidity, followed by diabetes (50%), pilonidal sinus disease (37.5%), and acne conglobata (25%). One patient (patient 7) with concurrent psoriasis ex- perienced a notable decrease in their Psoriasis Area and Severity Index (PASI) score from 10.3 to 0 after 6 months of secukinumab therapy, indicating effec- tive treatment for both conditions. In patients with HS, elevated serum levels of proinflammatory cytokines, CRP, and erythrocyte sedimentation rate (ESR) have been observed, re- flecting the presence of systemic inflammation com- pared to healthy controls. These inflammatory markers tend to increase with the severity of clinical inflammation and indicate the systemic inflamma- tory burden, especially in severe disease. Among them, IL-6, CRP, and ESR are considered helpful in evaluating the severity of inflammation in HS.14,15 Furthermore, the evaluation of inflammatory biomarkers, including CRP, ESR, and serum amy- Güllü GENCEBAY et al. Turkiye Klinikleri J Dermatol. 2025;35(3):82-8 87 loid A, plays a key role in monitoring disease sever- ity and assessing the risk of complications.16 Identi- fying serum biomarkers that can predict treatment response in patients with HS is essential. While sev- eral serum biomarkers have been investigated in re- lation to adalimumab response, data on biomarkers predicting response to secukinumab remain lim- ited.17 In our study, seven patients (87.5%) showed a decrease in CRP levels during treatment. However, one patient (Patient 4) developed pneumonia 2 months after initiating secukinumab and required hospitalization. The cause of pneumonia remains un- clear and may be related either to the immunosup- pressive effect of secukinumab or to the patient’s underlying chronic kidney disease. Despite elevated CRP levels, Patient 4 demonstrated improvement in the IHS4 score. Our study is valuable as it is one of the few that have reported changes in CRP levels as an inflammatory biomarker in HS patients treated with secukinumab. CONCLUSION In summary, our findings suggest that secukinumab may represent a promising and well-tolerated treat- ment option for patients with HS. However, due to limitations such as the small sample size, caution is warranted in generalizing these results. Further re- search involving larger and longer-term clinical tri- als is necessary to establish the long-term efficacy and safety profile of secukinumab in HS manage- ment. Source of Finance During this study, no financial or spiritual support was received neither from any pharmaceutical company that has a direct con- nection with the research subject, nor from a company that pro- vides or produces medical instruments and materials which may negatively affect the evaluation process of this study. Conflict of Interest No conflicts of interest between the authors and / or family mem- bers of the scientific and medical committee members or mem- bers of the potential conflicts of interest, counseling, expertise, working conditions, share holding and similar situations in any firm. Authorship Contributions Idea/Concept: Güllü Gencebay; Design: Güllü Gencebay; Con- trol/Supervision: Özlem Su Küçük; Data Collection and/or Pro- cessing: Nisan Çetin Yetimova; Analysis and/or Interpretation: Güllü Gencebay; Literature Review: Didem Dizman, Nisan Çetin Yetimova; Writing the Article: Güllü Gencebay; Critical Review: Özlem Su Küçük; References and Fundings: Güllü Gencebay; Materials: Güllü Gencebay. 1. Midgette B, Garg A. Epidemiology of hidradenitis suppurativa and its comor- bid conditions. J Am Acad Dermatol. 2024;91(6S):S3-7. [Crossref] [PubMed] 2. Gao JL, Otto TS, Porter ML, Kimball AB. Hidradenitis suppurativa: new tar- gets and emerging treatments. Am J Clin Dermatol. 2024;25(5):765-78. [Crossref] [PubMed] 3. van der Zee HH, de Ruiter L, van den Broecke DG, Dik WA, Laman JD, Prens EP. Elevated levels of tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-10 in hidradenitis suppurativa skin: a rationale for targeting TNF-α and IL- 1β. Br J Dermatol. 2011;164(6):1292-8. [PubMed] 4. Schlapbach C, Hänni T, Yawalkar N, Hunger RE. Expression of the IL- 23/Th17 pathway in lesions of hidradenitis suppurativa. J Am Acad Dermatol. 2011;65(4):790-8. [PubMed] 5. Kelly G, Hughes R, McGarry T, van den Born M, Adamzik K, Fitzgerald R, et al. Dysregulated cytokine expression in lesional and nonlesional skin in hidradenitis suppurativa. Br J Dermatol. 2015;173(6):1431-9. [PubMed] 6. Matusiak Ł, Szczęch J, Bieniek A, Nowicka-Suszko D, Szepietowski JC. In- creased interleukin (IL)-17 serum levels in patients with hidradenitis suppu- rativa: implications for treatment with anti-IL-17 agents. J Am Acad Dermatol. 2017;76(4):670-5. [Crossref] [PubMed] 7. Kimball AB, Jemec GBE, Alavi A, Reguiai Z, Gottlieb AB, Bechara FG, et al. Secukinumab in moderate-to-severe hidradenitis suppurativa (SUNSHINE and SUNRISE): week 16 and week 52 results of two identical, multicentre, randomised, placebo-controlled, double-blind phase 3 trials. Lancet. 2023;401(10378):747-61. Erratum in: Lancet. 2024;403(10427):618. [PubMed] 8. Martora F, Marasca C, Cacciapuoti S, Fariello F, Potestio L, Battista T, et al. Secukinumab in hidradenitis suppurativa patients who failed adalimumab: a 52-week real-life study. Clin Cosmet Investig Dermatol. 2024;17:159-66. [PubMed] [PMC] 9. Casseres RG, Prussick L, Zancanaro P, Rothstein B, Joshipura D, Saraiya A, et al. Secukinumab in the treatment of moderate to severe hidradenitis sup- purativa: results of an open-label trial. J Am Acad Dermatol. 2020;82(6):1524- 6. [PubMed] 10. Ribero S, Ramondetta A, Fabbrocini G, Bettoli v, Potenza C, Chiricozzi A, et al. Effectiveness of secukinumab in the treatment of moderate-severe hidradenitis suppurativa: results from an Italian multicentric retrospective study in a real-life setting. J Eur Acad Dermatol venereol. 2021;35(7):e441- 2. 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