Jennifer Hsiao, MD: IL-17 Inhibitors for Hidradenitis Suppurativa

Amid dermatology’s decade-long surge of novel drug approvals for psoriasis and atopic dermatitis, and first-time indications for chronic diseases like vitiligo and alopecia areata, one disease spaces has patiently waited for its pharmacological breakthroughs.

Hidradenitis suppurativa (HS), a common skin condition that results in large, painful subcutaneous lumps in intertriginous regions of the body, is treated with just 1 drug approved by the US Food and Drug Administration (FDA): adalimumab (Humira), indicated for HS in September 2015.

That may not be for long.

In an interview with HCPLive during the Fall Clinical Dermatology 2023 Conference for PAs & NPs in Orlando, FL, this weekend, Jennifer Hsiao, MD, clinical associate professor of dermatology at Keck School of Medicine of USC, discussed a couple of emerging drug classes with late-stage data supporting their efficacy and safety in treating HS.

The first, interleukin 17 (IL-17) inhibitors secukinumab and bimekizumab, have been supported by recent phase 3 data and has Hsiao anticipating their availability to patients potentially as soon as later this year.

“I think in general, the paradigm is hopefully shifting for patients with moderate to severe HS away from doing repeated courses of oral antibiotics, repeated incisions and drainages of their lesions,” Hsiao said. “Really, those are short-term band-aids, and not long-term therapeutic offerings.”

The current treatment strategy for HS is a combination of medical and procedural strategies including topical therapies, oral antibiotics and hormonal drugs, as well options to invasively remove lumps or inject steroid therapy subcutaneously.

What IL-17 inhibition provides is a simpler treatment offering by way of subcutaneous injection therapy, reduced cardiovascular safety risks relative to options including tumor necrosis factor (TNF) inhibitors, and proven efficacy in long-term disease management.

“Based on a patient’s comorbidities, based on their preferences, I think that really helps guide us in terms of where the IL-17 inhibitors will come into play,” Hsiao said. “And to be honest, a lot of it will also come down to formularies for these patients and what we as clinicians can get our hands on.”

The greatest benefit, though, may come from the luxury of biologic treatment options.

“Right now, I just think we need more treatment options,” Hsiao said. “We need to be able to offer something beyond just 1 FDA-approved therapy.”