What New Secukinumab Data Mean for HS Patients: A Q&A with Dr. April Armstrong

• Long-term (4- and 5-year) data presetned at AAD 2026 showed that early responders to secukinumab can sustain benefit, supporting durable chronic treatment in a chronic, relapsing disease like hidradenitis suppurativa (HS).
• Secukinumab was associated with sustained flare reduction, with many patients achieving and maintaining a flare-free state over extended periods.
• Despite therapeutic advances, there remains a significant unmet need due to incomplete disease control, high disease burden, and delayed diagnosis impacting outcomes.
• Safety profiles of IL-17 inhibitors remain consistent, and secukinumab shows a numerically lower rate of Candida infections vs bimekizumab (keeping individualized treatment models).

In the following Q&A, Dr. April Armstrong, professor and chief of dermatology at UCLA and a study coauthor, talks with Practical Dermatology aboutthe importance of new secukinumab data for patients with hidradenitis suppurativa (HS). Speaking on UCB's recently announced topline results in the BE BOLD head-to-head trial in psoriatic arthritis that showed bimekizumab achieving statistically significant superiority over risankizumab in reducing disease activity (measured by the stringent ACR50 endpoint) at week 16 in adults living with active psoriatic arthritis, she also noted how such data contribute to clinical decision-making across an increasingly complex therapeutic landscape.

PD: What do the 4- and 5-year efficacy data add to what you already knew about secukinumab?

Dr. Armstrong: From the original SUNSHINE and SUNRISE trials, we already knew that secukinumab could achieve meaningful clinical responses by week 16 and sustain those responses through one year. What has been less clear historically in hidradenitis suppurativa is whether those responses persist over multiple years in a chronic, relapsing disease.

The 4- and 5-year efficacy data  show that patients who respond early can maintain that response with continued treatment long-term.

From a clinical standpoint, that is highly reassuring. HS is not a short-term disease. It is chronic and progressive, and what we need are therapies that do not just work initially, but continue to control disease activity over time.

How important is it to continue improving HS therapeutics?

It remains important to continue improving HS therapeutics. As we saw in this study, longer-term data highlight secukinumab’s ability to help patients achieve and maintain a flare-free state. A high proportion of patients are free of flares early on, and importantly, many continue to remain flare-free over time, supporting durable disease control with ongoing treatment.

That being said, even with advances such as secukinumab, adalimumab, and bimekizumab, there is still an unmet need because there are patients who have not achieved substantial reduction in disease burden.  Additionally, HS carries a high burden, including chronic pain, scarring, impaired quality of life, and even increased mortality risk.

We also see delays in diagnosis that may cause patients to miss a potential window where earlier intervention could alter disease trajectory. 

What is important to note about the new safety data compared with bimekizumab?

The key point is that both agents have safety profiles that are generally consistent with what we expect from IL-17 pathway inhibition, with some differences that are clinically relevant.

One of the differences is the rate of Candida infections is numerically lower with secukinumab compared to bimekizumab. That said, it is important to put this into context. Most Candida infections reported with IL-17 inhibitors are mild to moderate, manageable, and rarely lead to treatment discontinuation. Both therapies remain highly effective options, and treatment selection should be individualized.

In practice, I think about these data in terms of patient-specific risk. For example, in a patient with a history of recurrent candidiasis or other predisposing factors, this may influence the discussion. But for many patients, both agents are effective choices, and the decision often comes down to the totality of efficacy, safety, and patient preference.