4CPS-058 Real-life study of effectiveness and quality of life in patients with moderate/severe hidradenitis suppurativa treated with monoclonal antibodies

<h3>Background and Importance</h3> Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that causes painful lesions in apocrine gland-bearing areas, significantly impacting patients‘ quality of life(QoL). Treatment combines surgical and medical therapies, with monoclonal antibodies(MoAbs) playing a key role. <h3>Aim and Objectives</h3> To evaluate the profile of patients with moderate/severe HS treated with MoAbs and assess treatment effectiveness and QoL outcomes. <h3>Material and Methods</h3> A retrospective observational study was conducted between 07/2016–03/2024 in a 3rd-level university hospital. Patients with moderate/severe HS treated with MoAbs were included. Data from clinical histories, including demographics, family history, Hurley index (HI), concomitant treatments and comorbidities, were collected. Effectiveness and QoL were assessed for all treatments lasting at least 12–16 weeks. Data on MoAbs received, treatment duration, and DLQI at baseline, weeks 12–16 and 48 were recorded. Continuous variables were expressed as means ± standard deviation and qualitative variables as percentages. <h3>Results</h3> Sixty-one patients were analysed: 55.74% male, mean age 39.26 years(±6.94), mean BMI 30.19(±6.94) and 62.30% smokers. 79.31% had HI-III, 29.50% had a family history of HS, and 63.38% had comorbidities, predominantly psychiatric (26.76%), immune-mediated (18.32%) and metabolic (14.09%). Among 87 MoAb treatments, the distribution was: Adalimumab 60.87%, Secukinumab 21.74%, Guselkumab 11.59%, Ustekinumab 2.90%, Bimekizumab 1.45%, and Risankizumab 1.45%. At the cut-off, 100% of patients remained on Guselkumab, Risankizumab, or Bimekizumab, while 47.37% were on Adalimumab and 47.06% on Secukinumab. Median duration on treatment ranged from 37 days (Bimekizumab) to 669 days (Ustekinumab). QoL improved with Risankizumab achieving a 91.67% reduction in DLQI at week 12–16, followed by Guselkumab (45.14%), Adalimumab (30.98%), Ustekinumab (28.01%), and Secukinumab (19.16%). By week-48, Guselkumab showed a 64.32% reduction, Ustekinumab 37.50% and Adalimumab 32.54%. <h3>Conclusion and Relevance</h3> This study underscores the complexity of managing patients with moderate/severe HS, often necessitating a multidisciplinary approach due to the high prevalence of comorbidities. While Adalimumab and Secukinumab are most commonly used, as they are the only biologics currently approved for HS, newer MoAbs used off-label under approved protocols show promising early results in terms of QoL improvements. Despite the limited sample size, these findings suggest that emerging biologics could offer valuable alternatives. Continued research is essential to validate their long-term effectiveness and safety profiles. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest