Povorcitinib for Hidradenitis Suppurativa: a narrative review on clinical trial Data with expert commentary

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disorder with a heterogeneous pathophysiology that typically affects intertriginous regions and presents with recurrent tender nodules, abscesses, and draining tunnels. Despite recent biologic approvals targeting tumor necrosis factor-α (TNF-α) and interleukin-17 (IL-17) pathways, some patients still experience incomplete or non-durable responses, highlighting the need for additional novel therapeutic targets. AREAS COVERED: This review summarizes current peer-reviewed published evidence on povorcitinib, an oral selective Janus kinase 1 (JAK1) inhibitor under clinical investigation for HS. Relevant literature was identified through PubMed and clinical trial registry searches, focusing on Phase II studies evaluating povorcitinib's efficacy, safety, and clinical utility. EXPERT OPINION: Povorcitinib has shown consistent improvement in disease activity and patient-reported outcomes, with a favorable safety profile across multiple dosing regimens. Overall, povorcitinib represents an important potential advancement in the HS treatment landscape, offering a potential oral option for patients with moderate-to-severe disease. Future research should elucidate its long-term safety, define predictive biomarkers of response, and determine its optimal role within a personalized, multimodal treatment framework.