Biologics can offer relief for severe hidradenitis suppurativa. Find out if they're right for you.
Lifestyle changes, antibiotics and hormone therapy are mainstays of treatment for mild to moderate stages of the chronic skin condition hidradenitis suppurativa. But if your condition is severe — with significant lesions, infections, and nodules and tunnels beneath your skin — and isn't responding to treatment, your doctor might recommend biologic drugs.
Biologic drugs are developed from living cells. They're effective against many types of inflammatory skin diseases, including psoriasis and eczema (atopic dermatitis). These drugs target different parts of the immune system to help the body fight diseases. They're usually administered weekly, either via injection or an IV infusion.
So far, the drugs infliximab (Remicade) and adalimumab (Humira) show the most promise in treating hidradenitis suppurativa. Adalimumab is the first biologic approved by the U.S. Food and Drug Administration for the treatment of hidradenitis suppurativa. These drugs work by neutralizing an immune system protein known as tumor necrosis factor (TNF), which stimulates inflammation in the body. You might be a good candidate for these drugs if your hidradenitis suppurativa doesn't respond to any other form of treatment.
Research suggests that biologic drugs can improve the symptoms of hidradenitis suppurativa. However, some studies found that after treatment stopped, skin lesions returned (relapse). More research is needed to determine the long-term effectiveness of biologic drugs as a treatment for hidradenitis suppurativa.
Not everyone is a good candidate for biologic therapy. The treatment is expensive and biologic drugs pose the risk for potentially serious side effects, including:
- Increased risk of infection, especially tuberculosis
- Heart failure
- A lupus-like syndrome
- Nerve damage in the brain and spinal cord
Other possible side effects include soreness and skin reactions where the drug is injected and skin infections at the injection site. Before treatment, you might need testing for certain infections, including tuberculosis.
If you're interested in biologic therapy to improve your hidradenitis suppurativa, talk to your doctor. He or she can answer your questions and determine if you could benefit from this type of treatment.
Dec. 29, 2018
- Dahl MV, et al. Hidradenitis suppurativa (acne inversa): Treatment. http://www.uptodate.com/home. Accessed Feb. 1, 2017.
- Ingram JR, et al. Interventions for hidradenitis suppurativa (review). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010081.pub2/full. Accessed Feb. 1, 2017.
- Lee RA, et al. Treatment of hidradenitis suppurativa with biologic medications. Journal of the American Academy of Dermatology. 2015;73:S82.
- Moderate to severe psoriasis and psoriatic arthritis: Biologic drugs. National Psoriasis Foundation. https://www.psoriasis.org/about-psoriasis/treatments/biologics. Accessed Feb. 19, 2017.
- Hidradenitis suppurativa: Diagnosis and management. American Academy of Dermatology. https://www.aad.org/public/diseases/painful-skin-joints/hidradenitis-suppurativa#treatment. Accessed Feb. 1, 2017.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. March 7, 2017.