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A double-blind placebo-controlled randomized trial of adalimumab in the treatment of hidradenitis suppurativa

Authors


  • Funding sources
    Abbott provided active drug, placebo and computer randomization. No salary was paid to the investigators or to the department performing the study.

  • Conflicts of interest
    I.M., C.D.L. and D.N.D. have participated as subinvestigators or coinvestigator in an Abbott-sponsored trial; G.B.E.J. and C.Z. have been investigators in an Abbott-sponsored trial and have received honoraria for lectures at Abbott-sponsored meetings; S.L. has no conflicts to declare.

Iben Miller.
E-mail: miller@dadlnet.dk

Summary

Background  Hidradenitis suppurativa (HS) has an impact on patients’ quality of life. Treatment of HS is generally unsatisfactory, thus new treatments are needed.

Objectives  To test the efficacy of adalimumab in HS.

Methods  This was a prospective, randomized, double-blinded, placebo-controlled, two-centre clinical trial conducted in Denmark. Inclusion criteria were age above 18 years and a clinical diagnosis of moderate to severe HS defined as Hurley stage II or III for at least 6 months. The patients were randomized 1 : 2 (placebo/active). Actively treated patients received adalimumab 80 mg subcutaneously (s.c.) at baseline followed by 40 mg s.c. every other week for 12 weeks. Placebo-treated patients received identical-looking injections with no active ingredient. The medicine was dispensed in sequentially numbered computer-randomized containers. Participants, care givers and those assessing the outcomes were blinded to group assignment. The primary efficacy endpoints were changes in the HS scores (Sartorius and Hurley scoring systems). Secondary efficacy endpoints included changes in pain (visual analogue scale), days with lesions and Dermatology Life Quality Index, and evaluation of scarring. Recruitment was terminated early due to expiry date of trial medication.

Results  Twenty-one patients were included, of whom 15 received adalimumab and six received placebo. All participants were analysed according to the intention to treat principle. A significant reduction was seen in Sartorius score after 6 weeks and an almost significant reduction was seen after 12 weeks of active treatment (−10·7 vs. 7·5, = 0·024 and −11·3 vs. 5·8, = 0·07) when compared with the placebo group.

Conclusions  A significant reduction in HS severity was gained after 6 weeks. No long-term curative effect was uniformly seen.

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