Infliximab for severe hidradenitis suppurativa: transient clinical efficacy in 7 consecutive patients.

Abstract

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.

LIMITATIONS:

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

CONCLUSION:

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.

• Authors: Laurence Fardet, Alain Dupuy, Delphine Kerob, Annabelle Levy, Matthieu Allez, Edouard Begon, Hervé Bachelez, Patrice Morel, Celeste Lebbé
• Journal: Journal of the American Academy of Dermatology (J Am Acad Dermatol) Vol. 56 Issue 4 Pg. 624-8 (Apr 2007) ISSN: 1097-6787 [Electronic] United States
• PMID: 17240478 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal
• Dermatologic Agents
• Infliximab

Topics

• Adult
• Aged
• Antibodies, Monoclonal (administration & dosage, adverse effects)
• Cohort Studies
• Dermatologic Agents (administration & dosage, adverse effects)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Hidradenitis Suppurativa (diagnosis, drug therapy)
• Humans
• Infliximab
• Infusions, Intravenous
• Male
• Middle Aged
• Patient Satisfaction
• Prognosis
• Quality of Life
• Risk Assessment
• Sampling Studies
• Severity of Illness Index
• Treatment Outcome