Secukinumab Efficacy Predictors in Korean Hidradenitis Suppurativa: A 48-Week Clinical Trial Analysis

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and draining tunnels commonly occurring in body folds. The IL-17A inhibitor, secukinumab, has shown efficacy in reducing HS lesions in clinical studies, but data on epidemiologic and patient-specific factors influencing response remain limited.

To assess how baseline disease severity, treatment initiation delay, and prior biologics exposure influence clinical response to secukinumab and patterns of antibiotic use.

This 48-week real-world prospective trial enrolled 10 Korean patients with moderate-to-severe HS. Patients received secukinumab 300 mg subcutaneously at weeks 0, 1, 2, 3, and 4, then every two weeks. Outcomes included Hidradenitis Suppurativa Clinical Response (HiSCR), a 55% reduction in the International HS Severity Score System (IHS4-55), mean change in abscesses and inflammatory nodules, a ≥ 30% reduction in pain score on a numeric rating scale (NRS30), and duration of concomitant antibiotic use.

At week 48, 90% of patients achieved HiSCR, with 90% meeting the IHS4-55 threshold and 60% reaching the NRS30 criteria. Faster responses were recorded in subjects with Hurley stage II, treatment delays of <10 years, or no prior biologics use, although response rates equalized by week 48. All patients, particularly moderate cases, either discontinued or transitioned to monotherapy with systemic antibiotics.

Secukinumab demonstrated efficacy in alleviating HS symptoms in moderate-to-severe cases. Patients with less severe disease, shorter treatment delays, and/or no prior biologic therapy exhibited more rapid initial responses. Additionally, the majority of patients experienced a significant duration of antibiotic cessation, underscoring the importance of early intervention. Future studies with larger populations are required to substantiate these findings.