Safety and Efficacy Profile of Anti-IL17 Treatments in Hidradenitis Suppurativa: Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials

Background and objective

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that is difficult to manage, requiring the use of biologic drugs such as anti-TNFα and anti-interleukin 17 (anti-IL17). The aim of our review is to evaluate the safety and efficacy profile of anti-IL17 drugs in patients with HS.

Materials and methods

We conducted a systematic review with subsequent meta-analysis following the population, intervention, comparison, outcome and type of study (PICOS) method. We included only randomized clinical trials with placebo (S) that included individuals with HS ≥ 18 years old (P), and who had been on placebo (C) OR, an anti-IL17 biologic drug (I) to measure safety and efficacy outcomes (O). Search was conducted across multiple databases: PubMed, Scopus, and the Cochrane Central Register of Controlled Trials. The risk of bias of each study, publication bias, sensitivity analysis, and certainty of evidence were determined.

Results

A total of 320 bibliographic references were obtained, 4 of which met the inclusion criteria. Compared to placebo, the meta-analysis showed a significantly higher percentage of patients achieving Hidradenitis Suppurativa Clinical Response (HiSCR) OR, of 1.96 [1.79–2.15], a greater decrease in DLQI, MD −1.92 [−2.68,−1.16] and an increase in adverse effects; OR, 1.21 [1.09, 1.34], particularly due to Candida infections; OR, 5.61 [2.66–11.83].

Conclusions

Treatment with anti-IL17 biologic drugs is effective in patients with moderate-to-severe HS. Although these drugs are safe, they should be monitored due to the risk of infections, mainly candidiasis.