Background/Purpose: Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory disease of apocrine sweat glands, characterized by recurrent abscessing inflammation. The prevalence is around 1-4% in young adults. Despite the prevalence of HS in the US it largely unstudied and treatment is extrapolated from studies done in a northern European population. Molecular drivers of HS are poorly understood, and traditional disease modifying anti-rheumatic (DMARD) therapies have been largely ineffective. Targeted biologic therapies including TNF-α inhibitors have been used with some success. Adjuvant biologic therapy after radical resection has been shown to reduce risk of recurrence in HS. The purpose of this study is to analyze the outcomes of patients with HS followed in our dedicated HS clinic and to assess how treatment with biologic agents affects disease activity scores including Hidradenitis Sartorius Score (HSS) and Hurley Stage in a US population.

Methods: This research was conducted through the Wound Etiology and Healing Study (WE-HEAL Study), an IRB approved biospecimen and data repository. All subjects gave written informed consent for longitudinal collection of their data while they receive treatment according to standard of care. At the time of data lock, of the 565 patients enrolled in the WE-HEAL study, 67 had HS. Modified Hidradenitis Sartorius Score (HSS) and Hurley Stage were analyzed according to medication exposures.

Results: Consistent with the known demographics of HS, the mean age of HS patients in this cohort was 40.12 ± 13.82 years, and they were 67.2% female and 71.6% African American. Mean HSS score at the first visit was 62.48 ± 47.45, and 67.2% were Hurley Stage III at the time of first visit. In this cohort patients treated with TNF inhibitor showed significant reduction in HSS score after treatment (mean HSS 74.88 ± 49.87 pre-treatment and 30.48 ± 42.18 post-treatment, p=0.0002).

Conclusion: The cohort of HS patients followed in the WE-HEAL study is representative of the population affected in the US with a high prevalence of women and African Americans. Treatment with TNF-α inhibitors was associated with significant improvement in disease activity scores in this population.