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Biologic Use in Pediatric Patients With Hidradenitis Suppurativa: A Systematic Review

Muskaan Sachdeva1, Patrick Kim2, Asfandyar Mufti3

  • 17938 Faculty of Medicine, University of Toronto, Canada.

Journal of Cutaneous Medicine and Surgery
|September 30, 2021
PubMed

Insights

Biologic therapies, particularly anti-TNF alpha inhibitors, show promise for treating pediatric Hidradenitis Suppurativa (HS). Most patients experienced partial or complete resolution with no reported adverse events, though larger trials are needed.

Area of Science:

  • Dermatology
  • Pediatric Rheumatology
  • Immunology

Background:

  • Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition affecting pediatric patients.
  • Adalimumab is the only biologic currently approved for pediatric HS in North America.
  • Limited data exists on the efficacy and safety of biologic treatments in this population.

Purpose of the Study:

  • To systematically review and summarize the outcomes of biologic therapy in pediatric patients diagnosed with HS.
  • To assess the effectiveness and safety profiles of different biologic agents used for HS in children and adolescents.

Main Methods:

  • A systematic literature search was conducted using MEDLINE and EMBASE databases on September 18, 2020.
  • Included studies focused on pediatric patients with HS treated with biologic agents.
  • Data extraction focused on patient demographics, HS severity, biologic agents used, treatment outcomes, and adverse events.

Main Results:

  • Fifteen studies involving 26 pediatric patients (mean age 15 ± 2.3 years) were analyzed.
  • Tumor Necrosis Factor (TNF) alpha inhibitors were the most frequently used biologics (85.3%), primarily adalimumab and infliximab.
  • Significant resolution rates were observed: 23.1% complete resolution and 73.1% partial resolution, with a mean time to resolution of 5.1 months. No adverse events were reported.

Conclusions:

  • Biologic therapies, especially anti-TNF alpha agents, demonstrate potential efficacy in managing HS in pediatric patients.
  • The current evidence base is limited by small study sizes and a lack of pediatric-specific clinical trials.
  • Further large-scale, prospective studies are warranted to confirm the long-term effectiveness and safety of biologics for pediatric HS.
Abstract

Keywords:
Hidradenitis Suppurativaacne inversabiologicpediatricsystematic reviewtreatment

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