RESEARCH - Long-term efficacy of a single course of Remicade in hidradenitis suppurativa

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Br J Dermatol. 2008 Feb;158(2):370-4. Epub 2007 Nov 28.

Long-term efficacy of a single course of infliximab in hidradenitis suppurativa.

Mekkes JR, Bos JD.

Department of Dermatology, Academic Medical Center, University of

Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

Background Hidradenitis suppurativa is a chronic inflammatory skin

disease characterized by abscess formation, predominantly in the

axillae and groins. The disease is difficult to treat and has a severe

impact on quality of life. Recently, several case reports have been

published describing successful treatment of hidradenitis suppurativa

with infliximab and other tumour necrosis factor alpha inhibitors.

Objectives To evaluate the long-term efficacy of a single course of

infliximab. Methods Ten patients with severe, recalcitrant

hidradenitis were treated with infliximab (three infusions of 5 mg

kg(-1) at weeks 0, 2 and 6) and followed up for at least 1 year. The

disease activity was measured using laboratory parameters and a

recently developed acne score. The patients rated the efficacy of

infliximab on a 10-point scale at regular intervals. Quality of life

was measured before and after treatment using the Dermatology Quality

of Life Index (DQLI). Results All patients improved within 2-6 weeks.

The average acne score diminished from 164 +/- 50 (mean +/- SD) before

treatment to 89 +/- 49 after 1 year (P = 0.002). The mean CRP

(C-reactive protein) was reduced from 31.7 mg mL(-1) to 5.5 mg mL(-1)

after 1 month (P = 0.015). Patients judged the efficacy with a score

of 7.9. The mean DQLI was reduced from 18.4 +/- 7.9 before treatment

to 9.3 +/- 9.1 after 1 year (P = 0.007). In three patients

long-lasting improvement was observed, with no recurrence of lesions

in a 2-year follow-up period. The other patients showed recurrence of

lesions after 8.5 months (range 4.3-13.4 months).

Conclusions Infliximab is an effective treatment in severe

hidradenitis suppurativa, leading to reduction of symptoms for a

prolonged period.

PMID: 18047504

http://www.ncbi.nlm.nih.gov/pubmed/18047504

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