ADOLESBIO-HS: A Real-World Multicenter Case Series on the Effectiveness and Safety of Adalimumab in Adolescents with Moderate-to-Severe Hidradenitis Suppurativa.

Introduction: Hidradenitis suppurativa (HS) is a chronic disease that causes painful skin lumps and scarring in the skin. In an important number of patients, the disease starts in adolescence. Adalimumab was the first biologic drug approved in adolescents with HS, yet approval was done on a model-based extrapolation from other diseases. Data regarding the effectiveness and safety of adalimumab in HS in this age group is lacking. Our objective was to describe the effectiveness and safety of adalimumab in adolescents with moderate-to-severe HS.

Methods: Retrospective multicenter case series. HS units across Spain were invited to participate, including all patients starting adalimumab in adolescence. Demographic, clinical, and treatment-related characteristics were retrieved. Effectiveness was measured as the proportion of patients achieving Hidradenitis Suppurativa Clinical Response (HiSCR) at 6 months. Safety was assessed by means of quantification and description of side effects over time.

Results: A total of 65 patients from 9 HS units were included. Mean age at adalimumab start was 15.5 years. A total of 76.9% of patients achieved HiSCR at 6 months. Side effects were observed in 7 patients, 3 of them requiring drug discontinuation, with full recovery. The adult dosage (80 mg every other week [EOW]/40 mg every week) was more frequently used. The median drug survival time for adalimumab was 5.6 years (25th percentile: 2.9 years), and the recommended adolescent dosage (40 mg EOW) was associated with a need for intensification (p < 0.001). The main limitations of the study are the lack of a comparison group and the retrospective design.

Conclusion: Adalimumab showed a similar safety profile in adolescents with moderate-to-severe HS as in adults, with better effectiveness data.