Efficacy and tolerance of prolonged infliximab treatment of moderate-to-severe forms of hidradenitis suppurativa

UNLABELLED: Hidradenitis suppurativa (HS) is a chronic suppurative disease impairing patients' quality of life (QOL). The standard treatment remains extensive surgery; medical treatment is often disappointing. OBJECTIVES: Prolonged infliximab efficacy and tolerance in moderate-to-severe forms of HS were evaluated. PATIENTS AND METHODS: This prospective, monocentric, open, interventional study concerned patients with progressive, moderate-to-severe HS ineligible for surgery, or who relapsed after surgery. Infliximab (5 mg/kg) was infused at weeks 0, 2 and 6, and then every 4 weeks. When the response was satisfactory, infusion spacing was attempted. RESULTS: Ten patients were included, 8 treated for 1 year, with a mean of 5 affected sites and 18 years of evolution. The mean initial DLQI was 20/30 (range 9-30). At 1 year, the number of involved sites (P<0.001) and flares (P<0.05) had decreased significantly under infliximab, as did HS severity. QOL improved clearly and rapidly for all patients, with mean DLQI at 6/30 (P<0.001). Tolerance was satisfactory with only 4 minor infections, 1 keratoacanthoma and one rapidly resolving hepatitis. CONCLUSION: This evaluation of prolonged infliximab use in HS after surgical failure showed good efficacy and satisfactory tolerance without therapeutic escape during the first year of treatment.