Dermal Tunnels Influence Time to Clinical Response and Family History Influences Time to Loss of Clinical Response in Hidradenitis Suppurativa Patients Treated with Adalimumab.

BACKGROUND: Clinical response in hidradenitis suppurativa (HS) is most commonly assessed using the Hidradenitis Suppurativa Clinical Response (HiSCR). Dermal tunnels, increased BMI, smoking and antibiotic use significantly decrease the odds of achieving HISCR. However, there is little data exploring if clinical features are also associated with length of time to achieve clinical response; and/or time to lose clinical response.

OBJECTIVES: To explore whether variables associated with achieving HiSCR are associated with time to achieve HiSCR and time to loss of HiSCR in HS patients treated with PIONEER OLE Adalimumab 40mg weekly.

METHODS: Time to event analyses were performed to estimate time to achieve HiSCR and time to loss of HiSCR. The log rank test was used to compare cumulative incidence curves for a priori patient and disease associated factors. Cox regression analysis was performed to compare time to event outcomes in the presence of a priori variables. All statistical analysis was completed in R version 3.5.3.

RESULTS: Presence of dermal tunnels significantly increased the time to achieve HiSCR (median 32.6 vs. 14.3 weeks, p=0.021) and the hazard ratio was significant after controlling for patient and disease factors (HR=0.70, 95%CI=0.51-0.96, p=0.03). A positive family history of HS significantly decreased the time to loss of HiSCR (median 11.4 vs. 18 weeks, p=0.00079) and remained significant in Cox regression analysis (HR=2.01, 95%CI=1.40-2.88, p=0.0001).

CONCLUSIONS: The presence of dermal tunnels significantly influences the odds of achieving HiSCR as well as the time to achieve HiSCR, while family history influences time to loss of HiSCR.