Improved clinical effectiveness of adalimumab when initiated with clindamycin and rifampicin in hidradenitis suppurativa

• Published in: Journal of the European Academy of Dermatology and Venereology 2024-05, Vol.38 (5), p.904-909
• Main Authors: Aarts, P., Huijstee, J. C., Zee, H. H., Straalen, K. R., Prens, E. P.
• Format: Article
• Language: English
• Subjects: Adalimumab - administration & dosage; Adalimumab - therapeutic use; Adult; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Clindamycin - administration & dosage; Clindamycin - therapeutic use; Drug Therapy, Combination; Female; Hidradenitis Suppurativa - drug therapy; Humans; Male; Middle Aged; Retrospective Studies; Rifampin - administration & dosage; Rifampin - therapeutic use; Severity of Illness Index; Treatment Outcome
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/jdv.19725

Background Adalimumab monotherapy for hidradenitis suppurativa (HS) is often insufficient with a maximum clinical efficacy of 60% in Hidradenitis Suppurativa Clinical Response (HiSCR) and limited effect on draining tunnels. Data suggest that adalimumab therapy could be improved by concomitant antibiotics. Objective To compare the clinical effectiveness of adalimumab with clindamycin and rifampicin versus adalimumab monotherapy after 12 weeks. Methods This retrospective study included patients who started adalimumab with additional clindamycin and rifampicin and patients treated with adalimumab monotherapy, matched on sex and refined Hurley score. The primary outcome measure was the difference in change in the International Hidradenitis Suppurativa Severity Score System (IHS4) at 12 weeks. Results In total, 62 patients were included in the combination therapy group (n = 31) and adalimumab monotherapy group (n = 31), showing comparable IHS4 scores; 32.5 versus 29, p = 0.87 at baseline respectively. The combination therapy demonstrated greater clinical effectiveness expressed in median IHS4 improvement (−20 vs. −9, p