Meta-Analysis IDs Promising Therapies for Hidradenitis Suppurativa

Key Takeaways

• Several approved and experimental agents, including sonelokimab and bimekizumab, showed superior HiSCR-50 response rates over placebo in moderate to severe HS in this meta-analysis.

• Adalimumab's efficacy was comparable to many emerging agents.

• Safety outcomes across were generally favorable; tolerability varied, especially with small molecule agents.

A new network meta-analysis comparing treatments for moderate to severe hidradenitis suppurativa (HS) shows several agents offering significantly improved efficacy over placebo.

Researchers reviewed phase 2 and 3 randomized clinical trials of 39 targeted therapies (including cytokine, small molecule, and cell inhibitors). The study included 5,767 patients across 26 trials. The outcomes of interest included Hidradenitis Suppurativa Clinical Response (HiSCR-50) at 12 to 16 weeks, as well as safety outcomes.

The following treatments were associated with significantly HiSCR-50 response rates, according to the study: sonelokimab (120 mg, every 4 weeks); lutikizumab (300 mg, every 2 weeks); adalimumab (40 mg, once per week); sonelokimab (240 mg, every 2 weeks); bimekizumab (320 mg, every 2 weeks); povorcitinib (15 mg, once per day); bimekizumab (320 mg, every 4 weeks); secukinumab (300 mg, every 4 weeks); and secukinumab (300 mg, every 2 weeks).

Most differences between adalimumab and other active therapies did not reach statistical significance. Safety profiles were similar across treatment arms, with serious adverse event rates ranging from 0% to 6%. Discontinuation due to adverse events reached as high as 15% for ropsacitinib.

"This network meta-analysis provides evidence for the comparative efficacy and safety of currently approved and pipeline medications for moderate to severe HS in the absence of head-to-head trials," the authors wrote.

Source: Garg A, et al. JAMA Dermatology. 2025. doi:10.1001/jamadermatol.2025.1976