Advances in biological therapies for hidradenitis suppurativa

Hidradenitis suppurativa is a chronic recurrent inflammatory skin disease, which occurs in the skin folds of axillary, inguinal, gluteal and perianal areas. The disease is often seen in young females, which is characterised by inflammatory nodules, abscesses, fistulae and scars. Patients with hidradenitis suppurativa have a long disease history and a reduced quality of life. Although its pathogenesis is still unclear, hidradenitis suppurativa is considered as a result of interactions between genetic factors and other environmental factors. At present, the therapeutic options are limited to antibiotics and other symptom-relieving measures. Aberrant immune responses, including increased cytokines, such as TNF-α, IL-17, IL-12 and IL-23, may play an important role. Considering that the pathogenetic mechanisms are understood, and observations are made when patients with concurrent hidradenitis suppurativa are treated with biological agents, biological treatment has gained considerable attention. Adalimumab, an anti-TNF-α monoclonal antibody, is currently the only biological agent approved by the US FDA based on the results of several clinical trials, which can treat hidradenitis suppurativa, but other biological agents targeting these inflammatory cytokines have also shown good efficacy and safety in the treatment of moderate-to-severe hidradenitis suppurativa. Based on a brief introduction to hidradenitis suppurativa, this review summarises advances in the biological therapy targeting immune factors involved in hidradenitis suppurativa.