The road to biologics in patients with hidradenitis suppurativa - a nationwide drug utilization study

Ring, Hans Christian, Yao, Yiqiu, Maul, Julia-Tatjana, Ingram, John R. ORCID: https://orcid.org/0000-0002-5257-1142, Frew, John W., Thorsen, Jonathan, Nielsen, Mia-Louise, Wu, Jashin J., Thyssen, Jacob P., Thomsen, Simon F. and Egeberg, Alexander 2022. The road to biologics in patients with hidradenitis suppurativa - a nationwide drug utilization study. British Journal of Dermatology 187 (4) , pp. 523-530. 10.1111/bjd.21673

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Abstract

Background Prolonged systemic antibiotic treatment is often a part of management of hidradenitis suppurativa (HS). While biologic therapies are now available, the patient’s treatment journey leading to biologic therapy is unclear. Objectives To examine treatment patterns and duration of systemic treatment use in HS patients preceding biologic therapy. Methods We identified all HS patients receiving treatment with biologics in the Danish National Patient Registry from 2010 through 2018 and extracted their entire prescription history of specific systemic treatments from the Danish National Prescription Registry since its inception in 1995.The patients’ treatment journeys were graphically displayed through Sankey diagrams, and generated box-plots to show temporal distributions. Descriptive patient characteristics were presented as frequencies with percentages for categorical variables and as means with standard deviations (SDs) or medians with interquartile ranges (IQRs) for continuous variables. Results A total of 225 HS patients were included. Patients had most frequently been treated with penicillin (n=214; 95.1%), dicloxacillin (n=194; 86.2%), tetracycline (n=145; 64.4%) and rifampicin/clindamycin (n=111; 49.3%), as well as the retinoids isotretinoin and acitretin, and dapsone. Prior to biologic therapy, patients received a mean of 4.0 (SD 1.3) different systemic therapies, across a mean of 16.9 (SD 11.3) different treatment series. The mean time from first systemic therapy until biologic therapy was initiated was 15.3 (SD 5.1) years (8.2 [SD 5.9] years when excluding penicillin and dicloxacillin). Conclusion HS patients who receive biologic therapy have long preceding treatment histories with multiple drug classes and treatment series, many of which are supported by relatively weak evidence in HS. Delay in the initiation of biologic therapy may represent a missed opportunity to prevent disease progression.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Wiley
ISSN:	0007-0963
Date of First Compliant Deposit:	4 June 2022
Date of Acceptance:	20 May 2022
Last Modified:	06 May 2023 09:21
URI:	https://orca.cardiff.ac.uk/id/eprint/150203

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