Assessing the Effectiveness of Intravenous Ertapenem in HS Patients

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by the blockage of pilosebaceous units in skin folds, which can lead to painful nodules similar to pimples, swollenness, and sinus tracts. It’s most common in patients younger than 55 years old, and even though clinicians are not sure what causes this skin condition, it’s possible that a patient’s hormones and immune system could trigger it.

Fortunately, it’s treatable, and catching it early can help minimize further problems, such as recalcitrant HS, which is a severe and progressive form of HS and is resistant to conventional therapies.

Recalcitrant HS poses a therapeutic challenge due to its chronic and relapsing nature, often requiring more aggressive or prolonged treatment approaches beyond standard care protocols. The management of recalcitrant HS may involve innovative strategies, like intravenous ertapenem therapy, to address the persistent symptoms and inflammation associated with this severe form of HS.

With that being said, let’s take a look into a recent study, titled “Efficacy and Durability of Intravenous Ertapenem Therapy for Recalcitrant Hidradenitis Suppurativa,” which was published in JAMA Dermatology in 2024.

Objective and Methods

The main objective of the study was to explore the optimal course duration, efficacy, and patient satisfaction associated with intravenous ertapenem for HS. The study aimed to assess the effectiveness of intravenous ertapenem in improving clinical outcomes, inflammatory markers, and patient satisfaction in 98 patients with recalcitrant HS by at-home, self-administered treatment of 1 gram of ertapenem. This was done between 12 to 16 weeks by a peripheral intravenous central catheter using an elastomeric pump.

Key Findings

Significant improvements were observed from baseline to post-therapy follow-up, including reductions in HS Physician Global Assessment scores, pain levels, C-reactive protein, interleukin-6, and leukocytes.

There was high patient satisfaction, with about 80 percent reporting medium to high satisfaction, and approximately 90 percent of patients were willing to recommend ertapenem to other patients.

Ongoing Research

The study emphasized improvements in clinical and inflammatory markers alongside heightened patient satisfaction. However, it also highlighted the importance of monitoring this approach for the emergence of antimicrobial resistance due to the longer-than-standard treatment course.

Ongoing research might need to include the need for larger, prospective, randomized clinical trials to further optimize the dosing and duration of ertapenem. Researchers could potentially aim to evaluate the coadministration of other therapies alongside ertapenem and develop strategies to maintain therapeutic outcomes effectively. This will hopefully help to enhance the understanding of the potential efficacy, safety, and long-term impacts of intravenous ertapenem on patients with recalcitrant HS.

References

Harde V, Mrowietz U. Treatment of severe recalcitrant hidradenitis suppurativa with  adalimumab. J Dtsch Dermatol Ges. 2009;7(2):139-141. doi:10.1111/j.1610-0387.2008.06918.x

My doctor says I have a skin condition called Hidradenitis Suppurativa. how is that normally treated? Harvard Health. December 2018.

Nosrati A, Ch’en PY, Torpey ME, et al. Efficacy and Durability of Intravenous Ertapenem Therapy for Recalcitrant Hidradenitis Suppurativa. JAMA Dermatol. Published online February 14, 2024. doi:10.1001/jamadermatol.2023.6201