title: Effective long-term control of refractory hidradenitis suppurativa with adalimumab after failure of conventional therapy.
abstract: BACKGROUND
  Hidradenitis suppurativa is a chronic suppurative condition featuring inflammatory nodules, fistulas and scars. It occurs predominantly in the axillae and groin. The disease is poorly responsive to any treatment and is connected with significant morbidity. Systemic therapy, including oral antibiotics, retinoids and antiandrogens, usually has only limited effect. Surgical treatment of affected areas is necessary in advanced stages.
  
  
  OBJECTIVE
  Several reports support the beneficial effect of tumor necrosis factor-α (TNF-α) antagonists for the treatment of severe hidradenitis suppurativa. By contrast with data on infliximab and etanercept, data describing the potential positive influence of adalimumab on disease outcome are limited and refer to only small cohorts of patients.
  
  
  METHODS
  Eight patients with severe, recalcitrant hidradenitis were treated for 1 year with adalimumab in a standard regimen and were subsequently followed for 1 year.
  
  
  RESULTS
  All patients improved within 4-6 weeks and laboratory parameters of C-reactive protein (CRP) and leukocyte count reduced significantly during treatment. Three patients demonstrated long-lasting improvement and five showed recurrences several months after discontinuation of the therapy. The average recurrence-free interval was 9.5 months.
  
  
  CONCLUSIONS
  Adalimumab is suitable for the long-term treatment of hidradenitis suppurativa and presents a further conservative treatment approach.
authors.affiliation: Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic. ma@avemedica.cz
authors.forename: Monika
authors.initials: M
authors.lastname: Arenbergerova
authors.forename: Spyridon
authors.initials: S
authors.lastname: Gkalpakiotis
authors.forename: Petr
authors.initials: P
authors.lastname: Arenberger
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D017497:Hidradenitis Suppurativa / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity; D012008:Recurrence; D012907:Smoking; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000068879:Adalimumab