New insights from the network meta-analysis of hidradenitis suppurativa treatments reveal that Sonelokimab, Lutikizumab, and Bimekizumab deliver significantly higher HiSCR-50 response rates—76.9%, 55.5%, and 52.8% respectively—compared to placebo, challenging clinicians to rethink how they evaluate hidradenitis suppurativa treatments in practice.
Despite these promising HiSCR-50 gains, treatment algorithms remain unsettled as no agent has yet surpassed the established efficacy of adalimumab, leaving specialists to navigate comparative performance without a definitive frontrunner among hidradenitis suppurativa (HS) pipeline medications.
Assessing hidradenitis suppurativa medication safety alongside efficacy, the same analysis demonstrates that rates of serious adverse events are statistically similar to those observed with placebo, underscoring that biologic innovation need not come at the expense of patient risk.
Emerging research invites us to consider lifestyle inflammation impact as a complementary axis of management. A recent investigation into the Tsimane Indigenous population challenges conventional notions of inflammaging—age-related chronic low-grade inflammation—revealing that traditional diets and activity patterns correlate with lower markers of chronic inflammation than seen in industrialized settings. This study of inflammation and aging skin suggests that environmental and behavioral factors modulate inflammatory processes in skin beyond pharmacotherapy.
By juxtaposing pharmacological advances with lifestyle-derived anti-inflammatory signals, clinicians can pioneer dual-pathway strategies that blend targeted biologics with patient-centered lifestyle modifications. Future research integrating dietary and physical activity interventions alongside standard-of-care biologics may uncover synergies that optimize outcomes and reduce long-term reliance on pharmacotherapy.
Key Takeaways:- Modern biologics for hidradenitis suppurativa, including Sonelokimab, Lutikizumab and Bimekizumab, achieve higher HiSCR-50 rates compared to placebo, yet adalimumab remains the benchmark.
- Safety profiles of new HS treatments align with placebo rates for serious adverse events, supporting cautious yet confident implementation.
- Lifestyle factors significantly affect inflammatory markers in skin, challenging traditional concepts of inflammaging.
- Integrating lifestyle interventions with pharmacological advances offers a holistic framework for managing moderate-to-severe hidradenitis suppurativa.