Effectiveness of ustekinumab for moderate-to-severe hidradenitis suppurativa: a case series

Hidradenitis suppurativa (HS) presents a difficult management. The therapeutic arsenal includes antibiotics, corticosteroids, retinoids, immunosuppressants and some biological drugs, being adalimumab the only one approved today. We present a series of 10 patients (median age 42.9, 6 females, 4 male) with moderate-to-severe HS treated with subcutaneous ustekinumab at doses of 90mg every 2 months. The clinical severity was assessed using the Hurley Staging System and Hidradenitis Suppurativa Physician Global Assessment (HS-PGA) scale. Systemic inflammation was evaluated using serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocytes levels. 90% of patients reached the Hidradenitis Suppurativa Clinical Response (HiSCR) therapeutic objective with improvement in the Hurley Staging System and HS-PGA, as well as decrease in monitored analytical parameters. 80% of patients presented a reduction of one degree in Hurley stage and all of them showed a decrease of at least one point in HS-PGA. No adverse effects were observed. These results support the use of ustekinumab as a feasible therapeutic option for HS, especially in cases that have failed to previous lines.