Infliximab for severe hidradenitis suppurativa: transient clinical efficacy in 7 consecutive patients.
BACKGROUND
Hidradenitis suppurativa (HS) is a chronic and debilitating disorder. Despite its significant prevalence, few reports of therapeutic studies are available. Recent case studies have reported the efficacy of antitumor necrosis factor monoclonal antibodies in treating the condition. In the study presented here, we assessed the safety and efficacy of infliximab in a series of patients with severe HS.


METHODS
We reviewed all consecutive patients with severe HS and treated with infliximab between October 2004 and December 2005. They were evaluated using the Sartorius severity score, a physician and patient overall assessment, and the Skindex-29 quality-of-life index. A substantive response was defined as marked or moderate overall improvement assessed by both physician and patient.


RESULTS
Seven patients were reviewed. All received at least 3 infusions of infliximab (5 mg/kg) in weeks 0, 2, and 6, and 5 patients received a fourth infusion at week 10. At week 6, a substantive improvement was seen in 5 patients. With the other 2 patients, any improvement was minimal or nonexistent. At week 10, there was a substantive response in 2 of the 5 patients. Adverse events occurred in 3 patients: abdominal pain caused by colon cancer, a multifocal motor neuropathy with conduction block, and a severe allergic reaction.


CONCLUSIONS
We have reported on only 7 patients. All had severe and chronic disease.


CONCLUSIONS
The efficacy of infliximab in patients with severe HS seems transient and is associated with significant toxicity. Prospective randomized studies are required to better assess the benefit-risk ratio of antitumor necrosis factor agents for this indication.
Fardet
Laurence
L
Department of Dermatology, Hospital Saint-Antoine, Paris, France. laurence.fardet@sat.aphp.fr
Dupuy
Alain
A
Kerob
Delphine
D
Levy
Annabelle
A
Allez
Matthieu
M
Begon
Edouard
E
Bachelez
Hervé
H
Morel
Patrice
P
Lebbé
Celeste
C
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D015331:Cohort Studies; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D017497:Hidradenitis Suppurativa / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D000069285:Infliximab; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D000069285:Infliximab