An evaluation of secukinumab for the treatment of moderate-to-severe hidradenitis suppurativa

ABSTRACT

Introduction

Until recently, biological therapy for hidradenitis suppurativa was limited to anti-tumor necrosis factor (TNF) blockade with adalimumab (ADA). However, not all patients respond to treatment with ADA. This highlighted the need for more therapeutic options. Interleukin (IL)-17/T-helper 17 (Th17) axis may play an important role in the pathophysiology of HS. Recently, the IL-17A inhibitor secukinumab, which targets IL-17A specifically and prevents it from interacting with the IL-17 receptor, has been FDA-approved for HS.

Areas covered

Secukinumab, represents a novel therapeutic strategy in HS management. An overview of structural and pharmacological characteristics is provided. Described efficacy in clinical trials and case reports and safety data from is presented.

Expert opinion

As response to anti-TNFas is lost over time, secukinumab has provided an alternative HS treatment option in clinical practice. Overall, secukinumab has shown good efficacy and a favorable side effect profile in HS clinical trials but may be avoided in patients with inflammatory bowel disease. Long-term and real-life data on the use of secukinumab are essential for improving decision-making in HS therapy.

KEYWORDS:

• Hidradenitis suppurativa
• Interleukin-17A
• efficacy safety
• secukinumab
• Th17

Article highlights

• IL-17A plays a key role in HS immunopathogenesis.

• Secukinumab is the first and the only FDA-approved IL-17A inhibitor for HS following the encouraging results of the two large phase III trials SUNSHINE and SUNRISE.

• The clinical efficacy rate was similar to the TNF inhibitor adalimumab and was maintained up to 52 weeks.

• Biologic approved therapies for HS are adalimumab and secukinumab.

• The safety evaluation of secukinumab in HS is similar to the other drug indications.

Declaration of interest

EJ Giamarellos-Bourboulis has received honoraria from Abbott Products Operations AG, bioMérieux, Brahms GmbH, GSK, InflaRx GmbH, Sobi and Xbiotech Inc; independent educational grants from Abbott Products Operations, bioMérieux Inc, InflaRx GmbH, Johnson & Johnson, MSD, UCB, Swedish Orphan Biovitrum AB; and funding from the Horizon 2020 European Grants ImmunoSep and RISCinCOVID and the Horizon Health grant EPIC-CROWN-2 (granted to the Hellenic Institute for the Study of Sepsis). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they are a consultant and investigator for Novartis, UCB and Moonlake Immunotherapeutics, particularly for secukinumab in HS. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was funded by the Hellenic Institute for the Study of Sepsis. The funder did not have any role in study design, content, and decision to publish.