Adalimumab for the treatment of hidradenitis suppurativa/acne inversa

INTRODUCTION: Hidradenitis suppurativa/acne inversa (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle that usually presents after puberty with painful, deep-seated, inflamed lesions in the apocrine gland-bearing areas of the body, most commonly the axillae, inguinal and anogenital regions. A mean disease incidence of 6.0 per 100,000 persons-years and a varying prevalence of 0.05-1% have been reported worldwide. AREAS COVERED: This manuscript summarizes the current evidence on chemistry, pharmacodynamics, pharmacokinetics, as well as clinical efficacy, safety and tolerability of the currently approved biologic drug adalimumab in the treatment of active moderate to severe HS in adults. Active, inflammatory lesions are expected to improve following 12 weeks of adalimumab treatment. The therapeutic response is greater following the registered weekly adalimumab (40 mg sc) administration in all clinical studies compared with the other treatments. Safety results were consistent with the known adalimumab safety profile. Expert commentary: Active, inflammatory lesions of HS are expected to respond to weekly administered adalimumab treatment. However, non-inflammatory, scarring lesions cannot respond to it. In such cases a combination treatment with radical surgery is required.