Analysis: Biologics Linked to Lower Cardiometabolic Risk in HS

Key Takeaways

• Biologic therapy was associated with a lower incidence of type 2 diabetes mellitus (T2DM) and cardiovascular events vs. no biologic use in a TriNetX cohort of more than 291,000 patients with hidradenitis suppurativa (HS), according to a new study in the Journal of Drugs in Dermatology. 

• IL-17 inhibitors were associated with lower risks of T2DM, myocardial infarction, and heart failure vs. TNF-α inhibitors.

• Biologic-treated patients also had fewer emergency department visits and hospitalizations.

Biologics were associated with a lower incidence of type 2 diabetes mellitus (T2DM) and cardiovascular events vs. no biologic use in a TriNetX cohort of 291,283 patients with hidradenitis suppurativa (HS), according to a new study in the Journal of Drugs in Dermatology.

Investigators conducted a large retrospective cohort study using data from the TriNetX Research Network, focusing on incident T2DM, cardiovascular events, and healthcare utilization among adults with HS treated with biologics compared with matched patients not receiving biologics. Among 291,283 adults with diagnoses of HS, 11,669 received adalimumab, secukinumab, or bimekizumab and were matched 1:1 by age, sex, and race to patients not treated with biologics.

The biologic cohort had a lower risk of incident T2DM (P = 0.03), myocardial infarction (P = 0.0003), stroke (P = 0.01), and heart failure (P = 0.0007) compared with no biologic use. Emergency department visits and hospitalizations were also reduced (P < 0.0001 for both). 

Classs-level analyses, in which 3,336 patients receiving IL-17 inhibitors were matched to 3,336 receiving the TNF-α inhibitor adalimumab, showed lower risks of T2DM (P < 0.0001), myocardial infarction (P = 0.02), and heart failure (P < 0.0001) when TNF-α inhibitors were used as the reference group. Emergency department visits and hospitalizations were also lower in the IL-17 cohort.

Reliance on administrative coding, potential residual confounding, and unknown medication adherence were cited as study limitations. 

"These results underscore the importance of considering cardiometabolic comorbidities when selecting biologic therapies for HS, as treatment choice may affect not only skin disease but also systemic health," the authors noted in the study.

Source: Li A, et al. Journal of Drugs in Dermatology. 2026;25(3):9732.