The US Food and Drug Administration’s (FDA) decision this week to approve secukinumab (Cosentyx) for treatment of hidradenitis suppurativa (HS) for adult patients represents the first indication to treat HS with a biologic that targets the interleukin (IL)-17A pathway.1

The drug is a drug class that has been viewed by experts in the dermatology space as impactful, with regard to management of the chronic, systemic skin disease.

Raj Chovatiya, MD, PhD, assistant professor of dermatology at the Feinberg School of Medicine at Northwestern University, answered several important questions about the FDA’s approval of the HS drug and about what it means for the present and future of treatment.

“It's a pretty exciting day for those of us that see patients with hidradenitis, particularly those that require systemic therapy,” Chovatiya said. “Just because it's been a good decade or so since we've actually had our last therapy that was available to us, which is adalimumab. It was, of course, a really important tool in the armamentarium for treatment.”

Chovatiya added that following the agency’s approval, there is now strong data to backup a different way of treatment, which he adds will hopefully give dermatologists hope for a different subset of patients that may not have been able to respond to other therapies previously.

Then, Chovatiya was asked about the significance of the use of an IL-17A pathway-targeting biologic like secukinumab important in the treatment of HS. He was also asked about differences with existing treatments.

“So with hidradenitis suppurativa, typically, we think about our topical therapies for those with milder disease, and then are systemic therapies for those that are progressing to more moderate-to-severe disease, where there's some longer term sequelae that you can see on the skin including scarring and tracks,” Chovatiya said. “Now typically, with our topical therapies, we're usually finding ways to control inflammation locally. Potentially, the use of antimicrobials or antibiotics are very, very commonplace. But there's a significant chunk of patients that will break through these treatments, necessitating the use of systemic therapies.”

Chovatiya also noted that, historically, dermatologists had fairly limited options for systemic therapies. Prior to the approval of TNF-alpha inhibition, in the case of adalimumab, Chovatiya noted that all that anyone would use was oral antibiotics.

Later, Chovatiya explained that this new approval may mark the beginning of a set of new possibilities for HS patients with few options in this space.

For further information on the approval, view the full interview clip posted above.

The quotes contained here were edited for the purposes of clarity.

References

1. ^{Kunzmann K. FDA Approves Secukinumab for Hidradenitis Suppurativa. HCPLive. October 31, 2023. Date accessed: November 1, 2023. https://www.hcplive.com/view/fda-approves-secukinumab-hidradenitis-suppurativa.}