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TOPLINE:

Golimumab demonstrated clinical benefit in treatment-refractory hidradenitis suppurativa (HS), with more than half of patients achieving a ≥ 55% reduction in disease severity.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using data from the University of North Carolina Health between January 2017 and December 2025.
• A total of 27 patients (mean age, 41.3 years; 85.2% female; 66.7% Black and 22.2% White) with treatment-refractory HS were included, all with ≥ 10 weeks of golimumab therapy, available baseline and follow-up lesion counts, and baseline International HS Severity Score System (IHS4) score > 4.
• Participants received either intravenous golimumab (17 patients, 63.0%) or subcutaneous golimumab (10 patients, 37.0%), with doses ranging from 200 mg to 300 mg every 3-4 weeks among responders.
• The primary outcome was IHS4-55, defined as a ≥ 55% reduction in IHS4 score from baseline, and the secondary outcome was the HS Clinical Response (HiSCR), which does not account for draining tunnel burden, unlike the IHS4.
• All 27 patients had prior adalimumab exposure, and 26 patients (96.3%) had prior infliximab exposure, representing a highly treatment-refractory population with mean baseline IHS4 score of 28.9.

TAKEAWAY:

• IHS4-55 was reported in 14 patients (51.9%); 10 of these received intravenous golimumab, and four received subcutaneous golimumab.
• Among responders, the mean IHS4 score decreased from 28.9 at baseline to 18.6 at first follow-up, with nine responders (64.3%) achieving IHS4-55 within 12 months of initiating treatment.
• HiSCR was achieved by 48.1% of patients overall, including 58.8% of those receiving intravenous therapy and 30% of patients receiving subcutaneous golimumab.
• Golimumab was generally well tolerated, with two adverse events (7.4%) reported: one case of psoriasiform dermatitis and one case of arthralgia.

IN PRACTICE:

“Golimumab may be associated with improvement in refractory HS,” the authors of the study wrote, adding that “randomized clinical trials are warranted to establish a safe and optimal dose.” They noted that compared with a previous report, the study “used higher or more frequent doses (200-300 mg every 3-4 weeks), suggesting that dose escalation may be necessary in treatment-resistant HS.”

SOURCE:

The study authors were Madeline Sage and Christopher J. Sayed, MD, Department of Dermatology, University of North Carolina at Chapel Hill. The study was published online in a research letter on June 10 in JAMA Dermatology.

LIMITATIONS:

The limitations included retrospective study design, small sample size, variability in golimumab doses and follow-up intervals across participants, and the inclusion of four participants from a previous cohort. Additionally, concomitant systemic therapies, which were used by 10 responders at the time of response, could have affected the observed clinical outcomes.

DISCLOSURES:

No funding was disclosed for the study. Sage and another author reported receiving personal fees, support, and grants from the University of North Carolina Medical Alumni Loyalty Fund, the Carolina Medical Student Research Program, and multiple pharmaceutical companies, including AbbVie, Novartis, InflaRx, Incyte, UCB, AstraZeneca, Sanofi, Sandoz, Takeda Pharmaceuticals, Sonoma Biotherapeutics, MoonLake Immunotherapeutics, Alumis, Elasmogen, and Cantargia.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.